Center on Aging: Medicare Drug Information: Where Do I Start?

Enhanced Tools Available to Help People with Medicare During 2006 Open Enrollment Period

Where Do I Start?

Medicare Prescription Drug Coverage Basics

Starting on January 1, 2006, Medicare began offering prescription drug coverage. In Iowa, people with Medicare selected from more than fifteen Medicare-approved drug plans sponsored by various private insurers wiith premiums ranging from $1.87 to $99.90 per month. Two helpful web-based tools are available from Medicare and the National Council on the Aging to help compare the costs and benefits of the Medicare-approved drug plans in Iowa and other states. (http://www.medicare.gov and http://www.benefitscheckup.org.)

Everyone who is eligible for Medicare is eligible for Medicare Prescription Drug coverage. You will need to decide if a Medicare drug plan will provide better coverage than what you have now.

For example, those who have drug coverage through a former employer or union may be better off to stay with their current retiree drug plan. But people who have no prescription drug coverage, or whose current drug plan covers less than Medicare’s plan, may benefit greatly by enrolling in one of the Medicare-approved drug plans. A decision to delay enrolling in a Medicare drug plan past your eligible enrollment date could result in a penalty with higher premiums over a lifetime.

Some people with limited financial means will qualify for extra help to cover their out-of-pocket costs for prescription drugs. Those who qualify and enroll in a Medicare-approved drug plan will get help in paying the drug plan’s monthly premiums, annual deductible, and co-payments. The Social Security Administration is accepting online applications for this extra help program. (https://s044a90.ssa.gov/apps6z/i1020/main.html)

Important Dates

January 1, 2006

Medicare drug coverage starts for people who enrolled in a plan by December 31, 2005.

May 15, 2006

Initial enrollment period for Medicare drug coverage ends.

June 30 , 2006

Medicare beneficiaries can switch plans until June 30, 2006.

November 15, 2006 - December 31, 2006

Next annual enrollment period.

January 1, 2007

Medicare coverage year begins.

Questions for people with Medicare

The next enrollment period

Current Medicare beneficiaries who did NOT enroll in a Medicare prescription
drug plan BY May 15, 2006 will be able to enroll this fall, beginning November 15, 2006. This enrollment period will end on December 31 and coverage will begin on
January 1, 2007.

For those who are currently enrolled in a prescription drug plan, they have the
opportunity to switch plans with no penalty. Keep in mind that coverage will
not begin until January 1 of the following year, for enrolling or switching
plans during this time period.

Can I switch plans?

For 2006, Medicare beneficiaries can switch plans until June 30, 2006 if
they already have a Medicare Advantage Plan or other Medicare Health Plan, (a
stand alone prescription drug plan) with prescription drug coverage. However,
they can only switch to another Medicare Advantage Plan with prescription drug
coverage or another Medicare Health Plan (a stand alone prescription drug plan)
that offers drug coverage. Likewise, through June 30, 2006, if they have a
Medicare health plan without prescription drug coverage but want to switch
plans, they can only join a plan that doesn't include drug coverage, as again
May 15, 2006 was the initial enrollment deadline for enrolling in prescription
drug coverage. And again, November 15 through December 31, 2006 is the n2006-10-27 11:48ll for the first time in
Medicare Prescription Drug coverage, which is the annual-enrollment period.

Do you have drug coverage as a veterans’ or military retirees’ benefit?

If you have prescription drug coverage through TRICARE-for-Life or the Veteran’s Administration, you need not enroll in a Medicare-approved drug plan. The drug coverage in both programs is as good as the new Medicare drug coverage. If you decide later to enroll in a Medicare-approved drug plan, the late enrollment penalty would not apply to you. (http://www.tricare.osd.mil/pharmacy/)

Will you first be eligible for Medicare after May 15, 2006?

People who become eligible for Medicare after May 15, 2006 will be able to enroll in a Medicare drug plan when they enroll for their other Medicare benefits.

Are you eligible for Extra Help:

Questions for people with limited income and cash resources

Are you single with annual income less than $14,355 and cash resources less than $10,000, or married with joint annual income less than $19,245 and joint cash resources less than $20,000?

If so, you may qualify for extra help paying for your Medicare-approved drug plan’s monthly premium, annual deductible and other costs. If you think you qualify, contact the Social Security Administration at 1-800-772-1213, or apply on-line. (https://s044a90.ssa.gov/apps6z/i1020/main.html)

After you apply for the extra help, you will also have to select a Medicare-approved drug plan. SHIIP counselors can help you apply for the extra help and compare the different drug plans. (http://www.shiip.state.ia.us)

Those who qualify for Extra Help can enroll in a Medicare Prescription Drug Program at anytime, even if they missed the May 15, 2006 deadline.

CLICK HERE for details.

MAKING MEDICARE MAKE SENSE -

updates from the Centers for Medicare and Medicaid