Medicare Prescription Drug Benefit: How It Could Affect Chiropractic Patients

NOTE: ACA has developed a Healthy Living Fact Sheet on Medicare Part C which DCs can use in their practice to alert their patients (members-only).

Introduction
The Bottom Line
Links
Medicare: What's With All The Parts?

Introduction

CLICK HERE FOR A DETAILED ARTICLE ON THIS TOPIC (10/13/06)

When faced with decisions about other areas of Medicare coverage, chiropractic patients may make choices that will affect their ability to access chiropractic care. The prescription drug benefit is where a lot of the confusion lies.

Beneficiares can access the new drug benefit in one of two ways: 1) by subscribing to a Part D plan or 2) by joining a Part C plan. Subscribing to a stand-alone Part D plan will not affect access to chiropractic care. However, many beneficiaries may decide to move into Part C, which significantly restructures the administration of many of their Medicare-covered services, and does have ramifications for such access.


The Bottom Line

Rumors that Medicare Part B patients will automatically lose their chiropractic benefits if they choose to supplement their existing coverage with one of the many Part D plans are not accurate.

DCs should keep in mind that the real threat to chiropractic access is if a current Part B beneficiary shifts to Part C to access the drug benefit.

DCs who have Medicare patients considering such a change may want to inform them that enrolling in Part C significantly changes the administration of all their Medicare-guaranteed services.

Doctors should advise them to check each of the items on this Healthy Living Fact Sheet (members-only). (If you are not a member of ACA, click here to join online.)


Links

* Government website with general info
* The New Medicare Prescription Drug Benefit: An Overview (a KaiserEDU.org tutorial)
* FAQ on Part D from the Center for Medicare Advocacy
* More info from the Center for Medicare Advocacy [scroll to the bottom for Part D-specific information]


Medicare: What's With All the Parts?
Here's a glance at how Medicare services are divided. Chiropractors generally deal with patients in Part B or Part C.

Medicare Part A: Covers hospital services.
Medicare Part B: Outpatient fee-for-service.
Medicare Part C: Medicare managed care (also known as Medicare Advantage; formerly Medicare + Choice)
Medicare Part D: Includes drug benefit plans administered by various insurers.