DBSA's Medicare Center

Many people are concerned about how the Medicare Modernization Act (MMA) will affect their care, especially people being treated for mental illness. DBSA’s Medicare Center is designed to help patients understand the new guidelines so that they can make informed choices in their health care coverage.

For the many people living with mental illness, continuous care is a critical issue.  Changes or interruptions in treatment and/or medication can have far-reaching effects on recovery – so understanding how Medicare works and preparing for change will be essential to their wellness plan.

WHAT WILL THESE NEW CHANGES MEAN TO MENTAL HEALTH CONSUMERS?

In 2003, a new Medicare plan was signed into law.  Before this, Medicare offered insurance for doctors and hospitals but didn’t cover drugs. The new law says that Medicare must offer prescription drug coverage to everyone who uses the program.

Medicare will offer drug coverage two different ways.  Both are optional – it will be your choice whether you want to sign up for this coverage.  Those who choose to be covered will pay premiums (an amount paid for insurance coverage) and some other costs, but Medicare will offer extra help to people with low incomes:

• Medicare will cover drugs through a temporary “drug card” program that’s already started.  This program isn’t insurance.  Instead, it offers discounts on prescription drugs.  The drug card program will end when the permanent Medicare benefit begins.

• Medicare will cover drugs through a permanent insurance benefit that begins in January 2006.

Private plans will provide the coverage for both programs.  Those who want to be covered will need to choose a plan.  Participants can change their plans but only once a year.

• For those of you who use the “fee-for-service” Medicare – you will choose a new Medicare Prescription Drug Plan.  These individuals will continue getting their other Medicare coverage the same way they always have or they can choose a managed care plan.