Medicare Drug Benefit Consult Service

Our Goals

1. To offer objective information regarding the Medicare drug benefit and the available prescription drug plans (PDPs) and Medicare Advantage-Prescription Drug (MA-PDs) organizations.
2. To assist the sign-up process by offering help to Medicare beneficiaries to facilitate a patient-guided drug plan decision.

Who Benefits

The Medicare Drug Benefit Consult Service will educate eligible Medicare beneficiaries about the available PDPs and MA-PDs.

• Dual Eligible—Dual-eligible beneficiaries are automatically enrolled into plans by mid-October at random, therefore assistance to educate the beneficiaries concerning the PDPs and Medical Center-contracted PDPs will reduce confusion in January 2006.
• SeniorCare and Circuit Breaker Medical Center beneficiaries—The consult service will contact these beneficiaries to provide information about the drug benefit.
• SeniorCare and Circuit Breaker, following January 1, 2006 will combine to become Illinois Cares Rx, a state prescription assistance program, helping to pay premiums, co-payments and deductibles for the new Medicare program.
• Illinois Cares Rx will contract with specific PDPs and MA-PDs. The consult service will make the information regarding these plans, as well as those contracting with the Medical Center, available to the beneficiaries.
• Illinois Cares Rx beneficiaries will be auto-enrolled into a plan if they do not sign up for one before December 31, 2005.
• All other eligible Medicare beneficiaries (aged 65 and older, Medicare-eligible disabled and individuals with end-stage renal disease)—The consult service will be available for those seeking assistance and education concerning enrollment into a Medical Center-contracted PDP or MA-PD during the initial enrollment period (November 15, 2005-May 15, 2006).

Navigating Medicare Part D

If you have questions about Medicare Part D and need more information in order to make an informed decision, please view our Navigating Medicare Part D presentation.

Referral Process

The Medical Center outpatient pharmacies will provide consult referral cards to all interested beneficiaries at the pick -up window of each pharmacy. The referral card will provide the phone number and address to the Medical Center Medicare Drug Benefit Consult Service.

The Medicare Drug Benefit Consult Service will receive referrals at a variety of points:

1. Refilling a prescription in any Medical Center pharmacy location. The pharmacy staff is aware that they can direct any interested patients to the service. Pharmacists/technicians can also check for Medicare prescription coverage eligibility and objectively educate the patient on the new drug benefit.
2. Referral from any Medical Center health care provider, including inpatient and outpatient clinical pharmacists, OCC registration desk receptionists, social workers, or financial case managers.
3. Patient self-referral. Referred beneficiaries or referring providers are encouraged to make appointments with the consult service, although walk-in patients will be accepted. The Medical Center Medicare Drug Benefit Consult Service will function out of the Wood Street Pharmacy, Pharmaceutical Care Center (PCC).

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