Deadline Approaching
for Potential Medicare Benefit!!!
First Application Deadline
August 16
If you are a Medicare recipient taking
Tracleer, you may be interested in applying for the Medicare Replacement
Drug Demonstration (MRDD). This provision is available to a limited
number of people with certain life-threatening diseases. PHA has
been working with the Centers for Medicare/Medicaid Services to
include Tracleer for the treatment of PH in this demonstration,
and we are pleased that PH patients who qualify will have a chance
to participate.
Not all people who qualify will be
selected. The program is available for a total of 50,000 people,
half of who must be chosen from a grouping of oral cancer treatments.
The remaining 25,000 people will be selected from a pool of multiple
sclerosis’s patients, rheumatoid arthritis patients and pulmonary
hypertension patients. CMS has designed the program so that applicants
will be selected randomly in two lottery style drawings. Once these
drawings are held and the 50,000 names drawn the slots will all
be considered filled. There will only be the two drawings.
Qualifying Conditions:
- You must have Medicare Part B,
and have or be able to obtain Medicare Part A
- Medicare must pay first for your
health care services (called the primary payer)
- You must have a signed document
from your doctor explaining that you need Tracleer
- You live in one of the 50 states
or the District of Columbia
- You don’t have any other
insurance that has comprehensive drug coverage (such as Medicaid,
an employer or union group health plan, or TRICARE)
Given that rheumatoid arthritis and
multiple sclerosis patients are in the non-cancer group and their
populations are much larger than PH, the number of slots going
to PH patients is totally dependent on the number of applications.
For this reason, it is imperative that, if you meet the above qualifications,
you submit an application by August 16, 2004.
This will mark the first “pool” of applicants. If your
application is not selected at that time, you will automatically
be entered into the second “pool.” Your chances of
being entered into the program will be greater if you apply
by the August 16 deadline. (They will accept applications
until mid September…but don’t wait too long)
The application form and other useful
information about this demonstration project is available at: www.cms.hhs.gov/researchers/demos/
drugcoveragedemo.asp or
call TrailBlazer’s demonstration call center at
1-866-563-5386 anytime
between 8:00 am and 7:30 pm, Monday through Friday (ET). TTY users
should call 1-866-563-5387.
For patients currently on therapy
and needing help getting and filling out the application, contact
the Tracleer Access Program (T.A.P.) toll free at 1-866-228-3546 and
Press #1 twice. Ask them for help getting and/or completing the
forms.
Remember… your
submission of the application does NOT mean that your name will
be drawn. To have a chance you must complete and submit your application
as soon as possible.
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Founded in 1990, The Pulmonary Hypertension Association (PHA)
is a nonprofit membership organization that provides a community
of hope,
support and education for patients and families affected by PH. Today,
there are almost 5,000 members benefiting from PHA’s numerous
services, including a patient-to-patient telephone helpline, support
groups, newsletters and conferences.
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