TO: NDSC Members and Affiliated Parent Groups
FROM: Susan Goodman, Director, Governmental Affairs
DATE: November 10, 2005

Prescription Drug Coverage to Change for Individuals Eligible for Medicaid and Medicare

Beginning January 1, 2006, Medicaid will no longer pay for prescription medication for those individuals who are eligible for both Medicare and Medicaid. Individuals with disabilities who are known as "dual eligibles" are generally those who qualify for benefits under the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program and are eligible for both Medicaid and Medicare. Individuals with disabilities who receive SSDI insurance benefits generally receive them because of the retirement, death or disability of a parent.

The Center for Medicaid Services (CMS) has mailed letters to all of those dually eligible individuals to let them know that they will now be enrolled in what is know as the Medicare Part D prescription drug plan.

According to the letter being sent by CMS:

"Starting January 1, 2006, Medicare will help pay for your prescription drugs instead of Medicaid. If you continue to be eligible for Medicaid, Medicaid will still pay for your health care costs that Medicare doesn't cover. To get Medicare prescription drug coverage, you will need to choose and join a Medicare drug plan. Call 1-800-MEDICARE (1-800-633-4227) for a list of the prescription drug plans with no premium in your area, other drug coverage options and help comparing plans and joining a plan that works for you. If you do not join a Medicare drug plan by December 31, 2005, Medicare will enroll you in (organization name and plan) and your coverage will begin January 1, 2006. With this Medicare-approved drug plan, you will pay

• $0 for your monthly prescription drug plan premium,
• $0 for your yearly prescription drug plan deductible, and
• $(Amount varies) co-payment when you fill a prescription covered by the plan."

• Content of IEPs;
• IEP team members;
• IEP meeting attendance;
• IEPs by agreement;
• reviewing and revising IEPs;
• Transition; and
• Alternate ways to participate in meetings