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It’s Time to Choose Your Medicare Part D Prescription Benefit Plan

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If you’ve 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 of 2006.

Part D is a new Medicare offering. Medicare has never offered a prescription plan before. That’s why you’re hearing so much about it now.

If you’re 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.

Don’t 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.

The ABCDs of Medicare

Medicare programs contain the following components:

  • Medicare Part A: This typically pays for inpatient hospital expenses. There’s no fee for Part A.
  • Part B: This is coverage for outpatient medical expenses, including doctor’s fees. There is a payment premium for this coverage.
  • Part 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 plans.
  • Part D: This is the new prescription drug plan.

The Medicare Part D basics

Here are 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

 

Visit Medicare.gov

Be sure to visit the Medicare Web page that provides a multitude of information about the new prescription coverage (http://www.medicare.gov/pdphome.asp). It includes:

  • Basic Information section
  • List of plans by state, so that you can compare cost and coverage
  • Section where you can enter the drugs you take now to find out which plans offer those drugs
  • Long list of frequently asked questions
  • Section where you can enroll online if you’ve already decided which plan you want 

Which enrollees seem to have had the most satisfaction so far?

Medicare 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 in common:

  • They chose a plan and stuck with it.
  • They 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.
  • They didn’t already receive generous state-provided drug benefits. Some states have been providing these kinds of programs for many years to low-income people.

Ask for help if you need it

If you’re 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.

Ask friends 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.



Source:
Medicare.gov; The New York Times, 26 March 2006; The Patient Advocate Foundation



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