Enrolling for Medicare Part D

Enroll Early (by May 15, 2006) to Avoid Penalties

For eligible individuals, there is a six-month open-enrollment period for Medicare Part D beginning November 15, 2005. Individuals who enroll late in Medicare Part D and who do not have coverage equal to Medicare Part D (Creditable Coverage), will incur a late-enrollment penalty of 1% per month for each month the individual is not enrolled. Individuals who enroll late in Medicare Part D and provide proof of Creditable Coverage will not be assessed a late-enrollment penalty.

Important Facts about Part D Enrollment: Sign-up begins November 15, 2005. Eligible individuals must enroll by May 15, 2006 or face penalties. Individuals who become eligible after November 15, 2005 must enroll by May 15, 2006 (or within 63 days of losing comparable coverage) or face penalties. The late-enrollment penalties will cost you an additional 1% of premium added to premium for each month the individual was not enrolled. That can add up over a year's time, and it will apply going forward.

Enrollment for Current Medicare Part A or Part B Users, and Medicaid Recipients

Individuals who currently are entitled to Medicare Part A and/or Medicare Part B may enroll in Medicare Part D after November 15, 2005. However, Part D will not pay for any drugs that could have been paid for under Medicare Part A or Part B, even if the individual does not have Part A or Part B. Individuals eligible for low-income assistance and Medicaid may also enroll beginning November 15, 2005.

CHANGING PLANS AND DIS-ENROLLING

In 2006, individuals who have chosen a Medicare Part D plan can change plans once (dis-enroll) from the program until May 15, 2006. From November 15 to December 31 of each year thereafter, individuals who have chosen a Part D plan can change plans for the following year.

Important Facts about Changing or Leaving Medicare Drug Plans: Enrollees may change plans once or dis-enroll from the program during the first 6 months of 2006. Individuals who do not sign up during the initial open-enrollment period ending May 15, 2006 likely will pay more for their coverage if they choose to enroll at a later date.

Transitioning to Medicare Part D

Because many people already have a specific drug regimen, Medicare Drug plans are required to establish an appropriate transition process for new enrollees.

• General Transition Process for New Enrollees

Part D plans will consider filling a temporary, one-time transition supply of a medication to cover the immediate needs of an individual while a request to maintain coverage can be made. Generally, a temporary supply of 30 days may be reasonable for new enrollees who present a prescription for a drug that is not available on their plan.

• Residents of Long-Term-Care (LTC) Facilities

Residents in LTC facilities may be enrolled automatically in a Medicare Part D plan. If they are currently using prescriptions that aren't covered on the new plan, an appropriate transition period of 90 to 180 days may be provided.

• Current Enrollee Transitions

An emergency appeals process is available to individuals whose level of care changes quickly as a result of an unplanned transition from one treatment setting to another.

Important facts about Making the Transition to Medicare Part D: In order to address the needs of individuals who are currently stabilized on a specific drug regimen, Medicare Part D companies are required to establish an appropriate transition process for new enrollees, current enrollees undergoing a treatment-setting change and residents of long-term-care facilities. Medicare Part D may fill a one-time transition supply of medication to cover immediate needs during the transition process. An emergency appeals process is available for unplanned transitions.

The process of enrolling in a Medicare Drug Plan is Simple

You can enroll in the MedicarePart D program by submitting an application to an approved Part D Sponsor. This application is used to verify an enrollee's eligibility, level of resources and income. Eligible individuals will receive information from Medicare in the fall of 2005 about plan options in their area. When an individual enrolls in a plan, it is the responsibility of the plan provider to notify Medicare of the choice of plan.

People currently on both Medicare and Medicaid will be automatically enrolled in a Part D plan in their area. They may choose to change the assigned plan before January 1, 2006, when Medicaid prescription drug coverage ends.

Important Facts about Enrolling in a Medicare Drug Plan: The Medicare Part D program application form will be used to verify an enrollee's eligibility, level of resources and income.

Key Dates for Enrollment

October 2005: Beginning October 1, eligible recipients will receive information from Medicare about Drug Plan options in their area. Beginning October 18, 2005 (or other date established by Medicare.gov), Part D Plan comparisons will be available on Medicare.gov.

November 15, 2005: Open enrollment begins.

January 1, 2006: First date Medicare Part D begins coverage, for those who have already enrolled. For "dual eligibles" Medicare Part D will replace Medicaid prescription drug coverage as of this date. Also, "auto-enrolled" recipients may switch plans.

May 15, 2006: End of first open enrollment period. Last day to switch plans for 2006.

November 15, 2006: Open enrollment period for 2007 coverage starts.

December 31, 2006: Open enrollment period for 2007 ends.

March 31, 2007: Last day to switch plans for 2007.