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NEW YORK STATE PSYCHIATRIC ASSOCIATION
A GUIDE TO THE MEDICARE PRESCRIPTION DRUG PROGRAM
FOR NEW YORK STATE PSYCHIATRISTS
BY SETH P. STEIN, ESQ. AND RACHEL A. FERNBACH, ESQ.
The following materials are intended to provide NYSPA members
with a basic understanding of the Medicare prescription drug benefit and
highlight key issues relevant to psychiatrists and their patients. We have
created the following outline to permit psychiatrists to link directly to
specific topics of information. Click on any “hot link” below to be taken
directly to that section of text. To read the information, you will need the free Adobe Acrobat Reader available here.
I. Introduction to Medicare Part D
II. Part D for the Typical Medicare Beneficiary
A. Basic Part D Benefit
B. Enrollment in Medicare Part D
C. Late Enrollment Penalty
D. Prescription Drug Plans, Generally
E. NYS Prescription Drug Plans
F. NYS Medicare Advantage with Prescription Drug Plans
G. How Part D Works with Other Health Coverage
H. How to Switch Plans
III. Part D for Dual Eligibles
A. Basic Benefit for Dual Eligibles
B. Mandatory Auto-enrollment for Dual Eligibles
C. New York State Benchmark Plans
D. Plan Selection Issues
E. New York State Medicaid Wrap-Around Program for Dual Eligibles
IV. Drugs Covered by Part D
A. Formulary by Class, revised 5/10/06
V. Exceptions and Appeals
VI. Pharmacies
VII. Low Income Subsidy and Extra Help
VIII. Other Resources
IX. Additional Information
A. Information from Centers for Medicare and Medicaid Services
B. What TO Do If You Can't Get your Medications
C. NY Appeals and Exceptions Contact List
D. Parts B & D Coverage Flashpoints Table
Members may also download and print a copy of the entire guide by clicking here.
Disclaimer: This section of the NYSPA website was
established to enhance access to facts about the Medicare Part D program and is
provided for general information purposes only. Content is subject to change
without prior notice at any time. We will make reasonable efforts to keep this
site current and to correct errors brought to our attention. Any links to
external Web sites and/or non-Part D information provided on this website are
provided as a courtesy and they should not be construed as an endorsement by
this website of the content or views of the linked materials.
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