Timetable for Action for Medicare Part D: Fall 2005 to 2006

What do you need to do...and when? Here is a quick look at key dates and deadlines.

Fall 2005: Parties outside the federal government have responsibilities to implement Part D.  These include:

• Medicaid agencies will send notices to Medicaid recipients who also have Medicare (called "dual eligibles") that they will be losing their Medicaid prescription drug coverage and will be enrolled in a Medicare Part D plan.
   
• Employers must send notices to the individuals for whom they provide health insurance, whether as an active worker, retiree, or dependent, telling them whether their current insurance has a drug benefit as good as the Part D benefit, or worse than Part D. If the insurance meets the definition of "creditable coverage," i.e., provides a drug benefit that is “actuarially equivalent” to the Part D benefit, then the individual may choose not to enroll in a Part D plan without having to pay a late penalty for delayed enrollment if he or she decides later to enroll in Part D. If the coverage is found not to be creditable coverage, then an individual will be penalized for delayed Part D enrollment. TIP: Be sure to save this letter from your insurer.
   
• Medigap providers that offer Medigap policies H, I, and J (the policies that include prescription drug coverage) must send notices to their policy holders. Providers must explain the changes to those Medigap policies the options available for their policy holders, and whether the policies meet the definition of creditable coverage.

Early Fall:

The Center for Medicare & Medicaid Services (CMS) selects a Part D plan for dual eligibles and notify them through an auto-enrollment letter. 

October 1, 2005:

October 15, 2005:

CMS sends information to all Medicare beneficiaries describing the Part D plans that will be available to them. Watch for the "Medicare & You" handbook with information about the plans available in your area.

November 15, 2005 - May 15, 2006:

This is the “Initial Enrollment” period for the Part D program for all beneficiaries. Current Medicare beneficiaries who enroll after May 15, 2006, will have to pay a penalty for late enrollment unless they can show that they had creditable drug coverage under another drug plan (see above).

January 1, 2006:

Medicare Part D prescription drug program starts for those enrolled prior to that date. Dual eligibles lose Medicaid coverage for their prescription drugs. Individuals who enroll between January 1 and May 15 will start coverage when they enroll. 

January 1-June 30, 2006:

If you're already enrolled in prescription drug coverage, you can switch to a different plan during this period.

May 15, 2006:

Last date to enroll in a Medicare prescription drug plan in 2006. Enroll before this date to save money on your prescription drug premium For every month you wait, your Part D premium goes up one percent (1%) unless you have other coverage as good as Part D (and in that case you should have gotten a letter from your provider telling you that your existing policy is considered "creditable coverage"; if you didn't get a letter then you will have to pay the extra premium. Or, if you got a letter and lost it, it will be more difficult to avoid the penalty.

July 1 - December 31, 2006:

You cannot switch plans during this time. You must keep the coverage you have until the end of 2006.