| MEDICARE PART D FACTS > Medicare prescription drug coverage is insurance provided by private companies that have been approved by Medicare. > Starting January 1, 2006, new Medicare prescription drug coverage will be available to everyone with Medicare. > This new drug coverage may help to lower prescription drug costs and help protect against higher costs in the future. > Enrollment dates are from November 15th, 2005 through May 15th, 2006 MEDICARE PART D BENEFITS > Safety net and peace of mind. Knowing that your monthly premium buys you the peace of mind of knowing that if your drug costs become very high, you will be protected. > Discounted prices. If you use the plan’s network pharmacies, you’ll have access to discounted prices. Plans will negotiate lower prices with drug companies and pass those saving along to you. > Choices in plans. You can change your plan every enrollment period if you’d like. > Medicare types of plans offered. Plans will come in two basic types. The most simple is a stand alone prescription drug plan which covers only drugs and can be used with your traditional Medicare and or a Medicare supplement (Medigap) plan. The other type combines a prescription drug plan with a Medicare Advantage plan that includes medical coverage for doctor visits and hospital expenses. This kind of plan is called a Medicare Advantage Prescription Drug (MA-PD). WHO IS ELIGIBLE > Part D plans are open to everyone who’s eligible for Medicare in the U.S and U.S. territories. > Persons 65 years or older, and some younger with certain disabilities. > You cannot be denied coverage for health reasons. > Participation is voluntary (however if you don’t join before May 15, 2006 your monthly premiums may be higher because there’s an additional fee for late enrollment. Please ask us if you have any questions regarding this penalty). FINANCIAL ASSISTANCE > There is extra help for people who need it. People with lower incomes get extra help from Social Security as well as State Pharmacy Assistance Programs. > Our advice is to go to your local Social Security office and obtain a 1020 form (which is specific for help with Medicare Part D Prescription Drug Coverage) > Social Security Administration: 800/772-1213 or www.ssa.gov > California State Pharmacy Assistance Program: Genetically Handicapped Persons Program: 800/639-0597 > Medicare Helpline assists with choosing a Part D plan, questions about coverage, and enrolling into a Part D plan: 800/MEDICARE (800/633-4227) STEPS TO FOLLOW FOR CHOOSING A PLAN 1. Determine your current coverage (i.e. Medigap supplement, HMO, PPO, Private Fee for Service, Cost Plan, or just Medicare A, B or both A+B) 2. Decide whether you’d like to have Medical and Pharmacy benefits with your plan. (This means that you will want a MA-PD rather than just a Stand Alone PDP, see above for definitions.) 3. Make a list of all medications currently taking 4. Compare different plans according to monthly premium, deductible, what % you pay for coinsurance, what amount you pay for co-payments, and the plans formulary (a formulary is a list of medications that the insurance companies have approved for patients to take) 5. Or call 800/MEDICARE and give the list of medications to the representative so that they may find you the most cost effective plan for you Because We Care (gp), because.we.care@gmail.com, Ask for Melissa or Adrianna |
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| Helping to understand PART D |
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