It’s Time to Choose Your Medicare Part D Prescription Benefit Plan
been putting off choosing your Medicare prescription plan, called Medicare
Part D, it’s time to face the music. May 15th is the end of the
initial enrollment period. After that, you won’t be able to enroll until November
is a new Medicare offering. Medicare has never offered a prescription plan
before. That’s why you’re hearing so much about it now.
like a lot of people, you’ve told yourself time and again that this weekend,
this evening, tomorrow morning, you’re going to sit down and wade through
the information to figure out what’s
right for you to do. And if you’re like a lot of those same people, you look
at the material for a little while, begin to feel overwhelmed and decide to
get back to it later.
be surprised if you’ve asked your grown children to help, and they feel as
overwhelmed as you do. If you’re not used to the terminology, this kind of
information can be hard for anybody to figure out.
ABCDs of Medicare
programs contain the following components:
Part A: This typically pays for inpatient hospital expenses. There’s no
fee for Part A.
B: This is coverage for outpatient medical expenses, including doctor’s
fees. There is a payment premium for this coverage.
C (now called Medicare Advantage): This offers a choice of options, including
Medicare HMOs and PPOs (managed care plans) and Medicare private fee-for-service
D: This is the new prescription drug plan.
Medicare Part D basics
a few things that we hope will clarify some issues for you
► You’re eligible for the program if you
are eligible for Medicare. It doesn’t matter what your income is, what your
health status is or how you currently pay for your medications.
► You’re not required to enroll in a Part D program, but if you wait until the
next enrollment period (it begins on 15 November 2006, and takes effect in
January of 2007), your premium payment will increase by at least one percent
for every month that you wait to join.
► The average cost for the Plan D benefit
is $35 per month.
► The drug benefit programs are approved
by Medicare, but they’re administered by private companies.
► The cost of the programs varies by program
and by the specific drugs you need coverage for.
► If you have a drug benefit now from a group
health plan, and you’d rather keep that benefit than enroll in the Medicare
program, make sure that plan will still be available to you. In fact, you
should have received a letter from the plan administrator already, letting
you know whether they will continue to offer coverage.
► People who have limited income and resources
may qualify for help with the monthly Part D payment. You can find out whether
you qualify and how to apply by calling Social Security at 1-800-772-1213,
or by visiting http://www.medicare.gov/pdp-basic-information.asp#ifmpdc
to visit the Medicare Web page that provides a multitude of information about
the new prescription coverage (http://www.medicare.gov/pdphome.asp).
of plans by state, so that you can compare cost and coverage
where you can enter the drugs you take now to find out which plans offer
list of frequently asked questions
where you can enroll online if you’ve already decided which plan you want
enrollees seem to have had the most satisfaction so far?
Part D enrollment began on 15th November 2005 and took effect in
January, so the people who enrolled at that time are already seeing results.
According to a March article in the New York Times, the ones who seem to experience
the most satisfaction with the new plan have the following characteristics
chose a plan and stuck with it.
relied on the expertise and skills of others, not on advertisements or even
their own instincts. In other words, they got help from Medicare experts,
insurance counselors, advisors from groups that specialize in senior issues
and even friends and relatives who were comfortable with the computer and
knowledgeable enough to use the “Plan
Finder” on the Medicare Web site.
didn’t already receive generous state-provided drug benefits. Some states
have been providing these kinds of programs for many years to low-income
for help if you need it
having trouble choosing a plan, be sure to ask for help. Call your local senior
center to find out whether they can offer advice. They may even offer high-speed
Internet service, so that you can go on the Medicare Web site and find the
information you’re looking for more easily.
if they’ve already chosen a plan, and if they have, how they made their decision.
If someone helped them, find out if you can get help from the same source.
Be persistent, because choosing the right plan for you is likely to pay off
in the long run.
Medicare.gov; The New York Times, 26 March 2006; The Patient Advocate Foundation