New York Medicaid and Medicare Part D: Working Together
White Plains, NY (Law Firm Newswire) May 17, 2013 - The state of New York has several major public health insurance programs, including Medicaid, commonly known as “Regular Medicaid.”
While Regular Medicaid in New York offers extensive health care services including: dental care; diagnostic testing; home care; hospitalization; mental health support; out-patient care at hospitals and community clinics; and physical therapy, clients of Medicaid in New York must receive their prescription drugs via Medicare Part D.
Any individual currently receiving or about to begin receiving New York State Medicaid must join a Medicare prescription drug plan, or they will lose their Medicaid benefits. When an individual becomes eligible for both Medicare and Medicaid, they are automatically assigned to a Medicare Prescription Drug Plan in order to not miss even one day of coverage.
Though a prescription drug plan is mandatory, enrollment in Medicare Part D is not; enrollment in another plan which better meets prescription drug needs is allowed. Patients are able to switch to another plan at any time.
Typically, as part of Medicare Plan D, the patient must pay a nominal amount, like a copayment, for the medication. Individuals who have full coverage from Medicaid while living in a residential home, an adult living or assisted living facility will likely be required to pay a small medication copayment for each medication. If an individual has full Medicaid coverage and resides in a nursing home, they will not be required to pay anything for covered prescription drugs.
Medicare's State Pharmacy Assistance Program (SPAP) for prescription drug coverage is determined by each state. New York State's Medicare's SPAP may determine that a patient should receive additional coverage when they join the Medicare Prescription Drug Plan, or may require the patient to enroll in a separate state program for prescription payment assistance.
Clients of New York Regular Medicaid must receive health care services through their managed care plan. Regular Medicaid in New York is available to single adults, childless couples at lower income levels, caretaker adults, the elderly, the disabled, and children, subject to some restrictions. Regular Medicaid may also provide retroactive coverage.
About Littman Krooks
Littman Krooks LLP provides sophisticated legal advice and the high level of expertise ordinarily associated with large law firms along with the personal attention and responsiveness of smaller firms. These ingredients, which are the cornerstone of effective representation and necessary to a successful lawyer/client relationship, have become the foundation of the firm’s success.
Littman Krooks LLP offers legal services in several areas of law, including elder law, estate planning, special needs planning, special education advocacy, and corporate and securities. Their offices are located at 399 Knollwood Road, White Plains, New York; 655 Third Avenue, New York, New York; and 300 Westage Business Center Drive, Fishkill, New York. For more information about Littman Krooks LLP, visit the website at: www.littmankrooks.com.
New York Contact:
Maria M. Brill
Littman Krooks LLP
New York City Office
655 Third Avenue, 20th Floor
New York, New York 10017
(212) 490-2020 Phone
399 Knollwood Road
White Plains, New York 10603
(914) 684-2100 Phone
300 Westage Business Center Drive, Suite 400
Fishkill, NY 12524
(845) 896-1106 Phone
View Larger Map
- Home Sharing May Be A Viable Option for Seniors
By Bernard A. Krooks, Certified Elder Law Attorney As baby boomers enter retirement, a trend is emerging: more and more single seniors are choosing to live with roommates. This living arrangement may be especially attractive to widows or widowers in retirement who own a home that is too large or expensive for one person. Other […]
- It’s Time to Protect Your Family and Your Future – 2015 National Financial Literacy Month
In support of the 2015 Improving Financial Awareness & Financial Literacy Campaign built around National Financial Literacy Month (April) and six month later during National Estate Planning Awareness Week (3rd week in October) the following estate planning article contains a very important message. Over 50% of our adult population does not have a current or […]
- Harper Lee Case and the Ability to Consent
Harper Lee, the author of To Kill a Mockingbird, is 88 years old and resides in an assisted living facility in Alabama. She has maintained a lifelong aversion to publicity and an insistence that she would never publish again. When HarperCollins announced that a book by Lee would be published in July, questions immediately arose. […]