Attention: Parents of Disabled Dependents

Medicare Part D, the new federal prescription drug plan, became effective on January 1, 2006 . Under this plan, Medicare will offer prescription drug benefits to an individual who is Medicare eligible, or receives both Medicare and Medicaid benefits (referred to as a dual eligible recipient).

A dual eligible recipient with disabilities usually receives Social Security and Medicare benefits and Supplemental Security Income (SSI) and Medicaid benefits. (The Social Security benefits are usually Disability Insurance benefits or Disabled Adult Child benefits received due to the retirement, death, or disability of a parent).

If your child receives both Medicare and Medicaid benefits, he or she MUST be enrolled in a Medicare prescription drug plan (PDP) as of January 1, 2006 , or he or she may lose all of their New York State Medicaid benefits, including health care coverage.  The Centers for Medicare and Medicaid Services (CMS) have randomly auto-assigned dual eligible recipients to a Medicare PDP.  CMS sent letters in November 2005 notifying dual eligible recipients of the PDP they will be assigned to, if they do not select a plan of their own.  Recipients can change plans at any time and may obtain assistance in choosing a plan by calling 1-800-MEDICARE (1-800-633-4227) or going to the CMS web site at www.medicare.gov/mpdpf.  In addition, the Health Insurance Information Counseling Assistance Program (HIICAP) provides free counseling and can help individuals compare and choose Medicare PDPs.  Call 1-800-333-4114 or visit www.hiicap.state.ny.us.

According to the NYS Department of Civil Service, the New York State Health Insurance Program (NYSHIP) will remain primary for covered, disabled dependent children of active employees.  In other words, the Empire Plan or your HMO will provide prescription drug benefits first and the Medicare PDP second.  The Medicare PDP will be primary and NYSHIP secondary for covered, disabled dependent children of parents who are no longer working (e.g. retirees).