As the start date of the Medicare Part D prescription drug program approaches, long-term care providers and pharmacists are getting edgy about the program’s effect on dual eligible residents.

While the government has ensured it will automatically enroll dual eligibles, or those who receive both Medicare and Medicaid assistance, some providers don’t know which plans these residents are enrolled in. Also, pharmacies cover different drug plans and might not all be contracted to serve that nursing home.

Another potential problem concerns those 65,000 dual eligibles who have private retiree health insurance. These residents might lose these benefits if they stay in the Medicare drug plan. About two-thirds of nursing home residents are dual eligibles.