Prescription Coverage on the Way

A group at Topeka's Lexington Park Retirement Village was a captive audience one recent afternoon as a HealthWise 55 volunteer described a program that could soon save them money.

It's Medicare D. It takes effect January 1, 2006, and HealthWise 55 volunteer Tom Miller says anyone age 65 and older without prescription drug coverage should consider it.

The program will carry a monthly fee around $35, along with a $250 deductible. After that, Medicare will pick up 75 percent of prescription drugs, up to $2250. You'll then pay 100 percent, until you reach $3600. Coverage then kicks back in, with the government picking up 95 percent of the prescription drug cost.

Miller, who is also a former head of Blue Cross/Blue Shield, says the investment is worth it. He says his analysis has found that people who spend $150 a month on prescription drugs will benefit from enrolling in this program.

The program replaces Medicare's interim prescription program, so you must sign up if you want any prescription coverage. Companies offering it may be sending information in the mail right now. Miller says you need to study the offers to be sure the prescriptions you're taking are covered by a particular company before enrolling with them. In addition, he says, people who travel a lot may want to enroll with a national company, in case they need to find a pharmacy on the road.

Enrollment begins November 15. Eligible people who don't sign up by May 15 will pay a higher cost. That's why Miller says you want to be careful in not enrolling, because you never know when an emergency might occur.

Miller says also watch the mail for the "Medicare and You - 2006" booklet. You should get it by mid-October. It tells you how to sign up and has more on the program.

If you're on a retiree drug plan with a former employer, companies are required to let you know if the program is continuing and whether it's as good as Medicare D.

Healthwise 55 can answer your questions about Medicare D. Call them at (785) 354-6787. You'll also find information on Medicare's website, www.medicare.gov.

WIBW Expanded Coverage from www.medicare.gov.

Introducing Medicare’s New Coverage for Prescription Drugs
CENTERS FOR MEDICARE & MEDICAID SERVICES
Starting January 1, 2006
Medicare will soon be offering insurance coverage for prescription drugs through Medicare prescription drug plans. Insurance companies and other private companies will work with Medicare to offer these plans. These plans will help you save money on your prescription drug costs. Medical practice has come to rely more and more on new drug therapies to treat chronic conditions and out-of-pocket spending on drugs has increased dramatically.

In order to get this prescription coverage, you must choose and enroll in a Medicare prescription drug plan that meets your needs. Here’s how you can get ready to take advantage of this new option:

*Look over your current health insurance coverage. Are prescription drugs covered?
*What are your out-of-pocket drug costs?
*Keep a list of the name, dosage, and cost of the prescriptions you use. Since different plans will cover different drugs, this will help you choose a plan that meets your prescription needs.
*If you have a limited income, check your mail this summer for an application to get extra help paying for a Medicare prescription drug plan. When you get this application, fill it out, and return it. Millions of people will qualify for a Medicare prescription drug plan with little or no premiums or deductibles, and low co-payments. You might be one of them.
*If you have prescription drug coverage through a former employer or union, check with your benefits administrator. Medicare prescription drug coverage may be different for you.

If you don’t use a lot of prescription drugs now, you still should consider joining. As we age, most people need prescription drugs to stay healthy. For most people, joining now means you will pay a lower monthly premium than if you wait to join until later.

Who can join? Anyone with Medicare Part A and/or Part B can join a Medicare prescription drug plan offered in their area. If you are in a Medicare Advantage Plan (like an HMO or PPO), your plan may also offer drug coverage.

When can I join? If you currently have Medicare Part A and/or Part B, you can join a Medicare prescription drug plan between November 15, 2005 and May 15, 2006. If you join by December 31, 2005, your Medicare prescription drug plan coverage will begin on January 1, 2006, and you won’t miss a day of coverage. If you join after that, your coverage will be effective the first day of the month after the month you join. If you join a Medicare prescription drug plan after May 15, 2006, you are likely to pay a higher monthly premium unless you currently have a drug plan that covers at least as much as a Medicare prescription drug plan. You will have to pay this higher premium as long as you have a Medicare prescription drug plan.

When can I get more information? Detailed information about Medicare prescription drug plans in your area will be available in the fall of 2005. Throughout 2005, Medicare will provide general information to help you get ready, including how to choose and join a plan that meets your needs.

In the fall of 2005, you will get the “Medicare & You 2006” handbook in the mail. It will list the Medicare prescription drug plans available in your area.

You will be able to get free personalized information at www.medicare.gov. on the web, or by calling 1-800-MEDICARE (1-800-633-4227) to help you choose the plan that meets your needs.

You can get free personalized counseling from your State Health Insurance Assistance Program (SHIP), and other local and community-based organizations. Call 1-800-MEDICARE to get the telephone number of the SHIP nearest you.


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