Medicare's newly added Part D, which will offer prescription drug plans, could mean bumpy changes in upcoming months for needy seniors as well as state officials.
According to the Seniors' Health Insurance Information Program at the N.C. Department of Insurance, registration for a Medicare Part D Prescription Drug Plan is available for all Medicare beneficiaries and is optional.
Private insurance companies approved by Medicare will sell the PDPs at monthly premiums.
Fred Eckel, executive director of the N.C. Association of Pharmacists, said the government has added Part D to Medicare in light of rising prescription drug costs.
"When Medicare was started 40 years ago, drugs were a small part of health care," he said. "It was never included as a coverage area. More recently, drug costs have become the biggest out-of-pocket costs for most people who don't have health insurance."
But the addition could cause problems for low-income seniors whose drug costs were formerly covered by Medicaid.
"People who are dually eligible - meaning that they are in both Medicaid and Medicare - they're going to be switched to Medicare coverage only," said Marisa Domino, professor in the UNC Department of Health Policy and Administration. "Medicare is going to be a lot less generous to these people than Medicaid would have been."
Whereas Medicaid is required by law to cover the costs of any drug, the selected insurance companies under Medicare Part D will have a "formulary," allowing them to choose the drugs they cover, Eckel said.
"The drug plan will negotiate between manufacturers to find the cheapest (drug), which reduces the total amount of drugs available for reimbursement," Domino said.
