Medicare Modernization Act Applications Due August 16 and September 30, 2004

As part of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, Medicare will extend coverage to prescription medications used to treat multiple sclerosis as well as other serious conditions including cancer, rheumatoid arthritis, and pulmonary hypertension. The demonstration project gives Medicare beneficiaries a preview of the significant savings scheduled for January 2006 when the Part D prescription drug benefit is fully implemented.

Up to $500 million will be spent on this demonstration project, which will help as many as 50,000 beneficiaries. To be eligible for the program, a beneficiary must be enrolled in Medicare Part A and Part B, and Medicare must be the beneficiary's primary health insurance.

Individuals with MS who are enrolled in Medicare will have two opportunities to obtain comprehensive coverage for any one of the four MS self-injected disease modifying therapies from September 2004 through December 2005. In addition to the financial benefits, the project also allows patients to inject their MS therapies at home.

The application process began July 6, 2004, and those who submit a completed application by August 16th will be eligible for early selection. About 10 percent of benefit recipients will be selected in this first lottery, and these people will begin their new coverage on September 1st. A second lottery is slated for September 30th, which is also the second application deadline. All applications received by this date will have an equal chance of being randomly chosen for this demonstration program.

Applications may be downloaded from the Centers for Medicare and Medicaid Services (CMS) website at http://www.cms.hhs.gov/researchers/demos/drugcoveragedemo.asp , and customer service representatives are available by calling (866) 563-5386. 

MSAA, along with other MS organizations, advocated for the Medicare Modernization Act. The staff at MSAA is pleased that this legislation will assist individuals with MS in obtaining coverage for their long-term treatments. 

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