What You Need to Know NOW About Medicare Part D

By Elaine Wiant and Carole Larkin

 

Q         What is Medicare Part D – the Medicare Prescription Drug Plan?

 

A         Medicare part D is the new insurance coverage for prescription drugs.  It is NOT a discount plan -- it REPLACES the current prescription drug discount cards.  It is voluntary – so you’ll have to make the effort to enroll. Unless you are very low income, you will not be automatically enrolled.   

 

Q         Who needs to know about this?

 

A         YOU do, if you’re eligible (see the next questions) or if a relative or friend is eligible.  In other words, everyone needs to know something about Medicare Prescription Drug Plans!

 

Q         Who is eligible to enroll?

 

A         Everyone who has Medicare, including people with Secure Horizons or an employer plan.

 

Q         When does it start?

 

A         Medicare part D starts January 1, 2006.  People can ENROLL beginning November 15, 2005. To begin using the plan on January 1, 2006, enroll between November 15th 2005 and December 31st 2005.  You can still enroll after that, but you can’t get benefits until you enroll and the costs may be higher, depending on when you enroll. 

 

New Medicare enrollees can enroll beginning on November 1, 2005.

 

Q         What information will eligible people get about Medicare part D and when will they get it?

 

A         There will be lots of general information in newspapers, on television and on the internet building up to the big announcement on September 15th 2005 of the approved drug plans for 2006. Medicare has already mailed notices to low income people who will be eligible to get help with paying for part D coverage. Everyone else who is eligible will receive the “Medicare and You” handbook from Medicare in October.

 

People enrolled in the Secure Horizons plan will receive information from Secure Horizons by the end of October.

 

People enrolled in employer sponsored plans will receive information from their plan in late summer or early fall.

 

People with Medigap plans (H, I, and J plans) will receive information by November 15.

 

Information will also be available on the Internet at www.cms.hhs.gov or www.medicare.gov or via telephone at 1-800-633-4227 (1-800-Medicare), or from community agencies and others. 

 

Plans will not be approved to begin marketing until October.  If you get mail or telephone calls trying to sell you a plan before October, BEWARE!  Plans are never permitted to solicit door-to-door.  Notify Medicare at 1-800-Medicare if you see a marketing practice you believe may be fraudulent. 

 

Q         What should I do now?

 

A         1.  Make a list of the prescriptions you routinely take. Write down the quantity, how often you order and the price.  If you pay less than full price, ask your pharmacist what full price is, and write that down too.

 

            2. Save the information you get in the mail.  If you currently get your prescription drugs from a plan (current or former employer, the VA, Tricare, a Group Health plan) you will receive information from that plan.  They must notify you no later than October how the plan will work for 2006.   

 

           3. Watch TV, check the newspaper for news on Medicare part D. Check www.medicare.gov and www.cms.hhs.gov.

 

           4. Talk to your religious groups, hobby or interest clubs, and community groups about having a knowledgeable person on this subject come to talk to the group or answer questions about Medicare part D.  

 

            5. Go to a meeting sponsored by a community group or club to hear more.     

 

 

This is one in a series of articles on Medicare Prescription Drug Plans and other topics important to “Third Age” (older adults), their friends and relatives. 

 

Carole Larkin is a Geriatric Care Manager with an M.A. degree in Applied Gerontology from University of North Texas.  Elaine Wiant is a Certified Fraud Examiner and Fellow of the Society of Actuaries.  They are owners of ThirdAge Services LLC, a provider of care services and financial services to older adults and their families and friends. 

 

Contact ThirdAge Services with questions or to request a speaker for your organization at 214-649-1392 or clarkin@thirdageservices.com.