Feds Eye Medicare Handbook Before Release

Since 05-24-05

From: Waspscpo@aol.com [mailto:Waspscpo@aol.com]
Sent: Tuesday, May 24, 2005 4:21 AM
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Subject: Feds Eye Medicare Handbook Before Release

 
http://abcnews.go.com/Politics/wireStory?id=778752

Feds Eye Medicare Handbook Before Release


The Associated Press
WASHINGTON, May 21, 2005

— Federal health officials are revising the draft of a Medicare handbook to give a more clear explanation of new rules on benefits, particularly on prescription drugs, before it is sent to millions of elderly Americans. "The handbook goes out in the fall to all Medicare beneficiaries," said Gary Karr, a spokesman for the Centers for Medicare and Medicaid Services.

"We sent out an early draft to a wide range of policy experts outside the agency, ranging from insurers to liberal advocacy groups." The agency has gotten feedback from many of the groups asking for clearer explanations of the new benefits which some health policy experts initially warned were complicated enough to cause confusion.

The handbook will be revised to make a more clear distinction between Medicare programs administered through private health maintenance organizations and preferred provider organizations and the more traditional fee-for-service Medicare programs used by millions of people, Karr said. "Some complained that we were mixing the details of the two programs too closely," Karr said.

"We will also be providing more details about payments and coverage on prescription drugs." The draft of the handbook did not provide details about the gaps in prescription drug coverage. After the beneficiary pays a $250 deductible, Medicare pays three-fourths of the next $2,250 in drug costs. There is no benefit between $2,250 and $5,100, a $2,850 gap in coverage.

But once a beneficiary has spent $3,600 on drugs out-of-pocket, including the deductible and copays, the government pays all but 5 percent of additional drug costs. Some groups have questioned whether the handbook should make claims that private plans offer a better value than traditional Medicare.

The guidebook also says the new drug benefit will be superior to coverage available under existing insurance policies that supplement Medicare, a claim some critics dispute. The handbook is being tested in focus groups of beneficiaries to make sure it is clear before it is sent out to all beneficiaries, Karr said.
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Contributed,
YNCS Don Harribine, USN(ret)