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Medicare Drug Info

 
Answers to your questions about Medicare Part D

 

Find which situations best fits you, and what to do next.

Confused with too much information? Find which of these situations best fits you, and narrow down your options. Remember, sometimes too much information can make it difficult to know exactly what applies to you, and your particular situation.

  If you have a Medicare prescription drug discount card:

You'll need to join a Medicare prescription drug plan (PDP) if you want prescription drug coverage. You can use your drug discount card until May 15, 2006, or until the date you join a Medicare prescription drug plan (whichever is earlier).

  If you don't have prescription drug coverage:  

If you have Medicare Parts A or B, you can join one of the new Medicare prescription drug plans if you want. Before you do, check out the plans to find one that may help you save money on drug costs. Enroll anytime between November 15, 2005 and May 15, 2006; the coverage becomes effective as of January 1, 2006 or the date you join (whichever is later).

  If you have prescription drug coverage through a Medicare Advantage HMO or PPO plan:  

You will be automatically enrolled in Part D and can keep your drug coverage for as long as you have the plan. If you enroll in a PDP by itself, you will lose your Medicare Advantage coverage.

  If you are are in a Medicare Advantage Private Fee-for-Service (PFFS) plan:  

You will be enrolled automatically in your plan's prescription coverage if your PFFS plan offers a PDP that is as good as the standard Medicare prescription coverage (called "creditable coverage"). If your PFFS plan doesn't offer a PDP that is as good as the standard Medicare coverage, you can enroll in a separate PDP.

  If your current Medigap policy (Medicare Supplement) does not include drug coverage: 

You can keep that plan and enroll in a PDP or you may chose to receive your Medicare benefits, including prescription drugs, through a Medicare Advantage plan.

  If you have prescription drug coverage through a Medigap policy:  

Your insurance company is required to notify you this fall whether your drug coverage is as good as the standard Medicare drug coverage. If it is, you can keep what you have. If you don't, you might want to consider joining a PDP or not. Joining a PDP will replace your existing prescription drug coverage and is optional not mandatory. But remember this: if you don't have coverage that is a good as the new Part D, if you wait until after May 15, 2006 to join then you will have to pay an additional 1% per month for every month that you join late.

  If you have had prescription drug coverage through Medicaid: 

You are considered a "dual eligible" under the new rules. Medicaid will continue to pay for your prescriptions only until December 31, 2005, when Part D becomes effective and Medicare will begin providing your prescription coverage. If you act between November 15 and December 15, 2005, you can choose a Medicare drug plan. Otherwise, you will be automatically enrolled in one of the plans in your area. You will not pay a monthly premium or deductible although you may a small copayment for your prescriptions.

  If you have prescription drug coverage through a state-sponsored pharmacy assistance program:  

Call your state's health insurance assistance program office to find out how the Medicare drug benefit affects your current coverage. This may be called the State Health Insurance Information Program (SHIIP) or State Health Insurance Program (SHIP). For help finding your local office, you can call 1-800-MEDICARE (1-800-633-4227) or TTY: 1-877-486-2048, 24 hours/day, 7 days/week.

  If you have prescription drug coverage through your union or former employer or if that coverage is cancelled:  

Your union or former employer is required to notify you this fall as to whether your drug coverage is as good as the standard Medicare drug coverage. If it is, you can keep your current coverage if you want. If it isn't, you need to weigh your options since you will have to pay an increased premium if you don't joing a PDP by May 15, 2006 and decide to join later. If your current drug coverage is cancelled, you can enroll without a penalty in a Medicare drug plan.