Article appeared in 2005
January 1, 2006, marked a big day for people on Medicare. It’s when Medicare began to offer coverage for both brand-name and generic prescription drugs. This is called Medicare Part D. A good way to remember that is to think of “D” and the word “drugs.” This is the biggest change to Medicare in 38 years. Previously, Medicare offered no coverage for prescription drugs for people who were not in a hospital or a long-term-care setting.
Now, Medicare is offering a benefit that works like insurance; you pay a monthly premium and a “co-pay” to take advantage of the benefits. To enroll in Medicare Prescription Insurance, you must already be eligible for Medicare Part A and/or Part B. Enrollment is voluntary. Medicare Prescription Insurance is designed to help seniors cover the rising costs of prescription medicines. Here’s what you need to know:
THE TIMETABLE
Medicare Prescription Insurance starts on January 1, 2006. If you are eligible, the "initial open enrollment period" is between November 15, 2005, and May 15, 2006. Medicare is encouraging everyone who is eligible to sign up, even if they don’t currently have many prescriptions. If you enroll during this initial open enrollment period, you’ll pay the lowest monthly premium. If you don’t sign up by May 15, 2006, you may have to pay up to a 12 percent penalty for each year you wait to sign up. So, if you think you might need Medicare Prescription Insurance later, you could save money by signing up now. After this initial open enrollment period, you’ll be able to change your plan during open enrollment periods each year from November 15 through December 31.
THE PLANS
Medicare has approved multiple insurance companies and other insured, private companies to provide a wide choice of plans. The details of all the plans were released on October 1, 2005. Learn more about the plans in the “Medicare & You 2006” handbook, which was mailed to all Medicare recipients. You can also look under the “Search Tools” option on the Medicare web site at www.medicare.gov. Other types of information are available at Walgreens pharmacy. Ask your Walgreens pharmacist for more details. Remember that diabetes supplies, like meters and test strips; diabetes self-management training and medical nutrition therapy; and several other diabetes benefits continue to be covered through Medicare Part B.
QUESTIONS TO CONSIDER ABOUT THE PLANS
- Does this plan cover my area of the country? There will be plans that cover small areas—or regions—of the country, or the whole United States. If you spend time in several states during the year, you may want to choose a national plan. If you live in one place and don’t plan to move, a local plan may suit you best.
- Does the plan cover the medicines you take now or may need in the future? The plans are not required to cover every drug, but they have to cover every type of drug. For instance, there are multiple cholesterol-lowering drugs available. Each plan will cover at least one of these drugs but may not cover the specific brand that you may be taking. Review the plans that are offered in your area to look for the drugs you take now and may take in the future. Choose a plan that is a good match for you. If your health care provider believes you need to take your current prescription drug and should not switch to another, you can contact your plan and ask for an exception.
- Does the plan have a good reputation? Talk with friends and relatives about the plans they are choosing and why. Talk with your Walgreens pharmacist or health care providers for information to help you select a plan.
- Does the plan include my pharmacy in its network? Make sure the pharmacy you like to go to is included in the plan’s network. Walgreens is proud to accept nearly all Medicare Prescription Insurance plans nationwide.
THE COSTS
The monthly premium, or amount that you pay every month, for Medicare Prescription Insurance is about $32. This is in addition to the premiums you pay for Medicare PartA and/or Part B. You will also pay a co-pay for each prescription you pick up at the pharmacy. This amount varies from plan to plan.
EXTRA HELP FOR LIMITED INCOME
If you have limited income, you may qualify for extra help. If you do, you likely received a letter from the Social Security Administration or Medicare. The extra financial help will assist with paying for the annual deductible, premiums and co-payments. Your eligibility will be reviewed every year to see if you continue to qualify. You automatically qualify for extra help if you have Medicare now and get full coverage for prescriptions from your state Medicaid program. Medicare encourages you to join a plan by December 31, 2005, because Medicaid won’t pay for your prescriptions after January 1, 2006. Medicare, not Medicaid, now will cover all of your prescription drug costs. You also automatically qualify for extra help if you get help from your state Medicaid program to pay your Medicare premiums (belong to a Medicare Savings Program) or get Supplemental Security Income. If you are not sure whether you qualify for extra help, go ahead and apply. There’s no risk or cost. Call (800) 772-1213, go to www.socialsecurity.gov or apply at your State Medical Assistance or Social Security office.
EXISTING DRUG COVERAGE
You may wonder if you should sign up for Medicare Prescription Insurance if you currently have a drug plan. Some seniors have a Medigap policy, retiree coverage or coverage from an employer or union. The group that provides you with that plan should have sent you a notice telling you two things: (1) whether your policy covers as much as or more than a Medicare prescription drug plan and (2) what your rights and choices are. If you have not received information regarding your current plan, make sure to contact your current plan administrator. Medicare advises that if your current plan covers as much or more than a Medicare plan, you should keep your current plan. You’ll be able to join a Medicare plan later and you will not have to pay any penalties. If your current plan isn’t as good, Medicare suggests you drop your current plan and join a Medicare plan.
WHERE DO I GET ENROLLMENT FORMS?
You can enroll in a Medicare Prescription Insurance Plan in a few ways:
- Fill out a paper application: Contact the company that offers the plan you are interested in and request an application. Fill out the form and mail or fax it back to the company.
- On the plan’s web site: Go to the drug plan’s web site and complete the application.
- Call the toll-free, 800 number provided by the plan to request a form and more information.
- On the Medicare web site www.medicare.gov. Medicare will have an enrollment center online
- Call Medicare at 1-800-MEDICARE (663-4227). Talk with a Medicare customer service person.
HOW TO PAY
In general, there are three ways to pay your Medicare Prescription Insurance premiums:
- Give permission to your selected plan to deduct the premium automatically from your bank account.
- Have your premium deducted every month from your Social Security benefits, similar to your premiums for Medicare Part B.
- Pay the prescription drug plan directly for your premium by mailing a check or money order each month.
WALGREENS: FOR MEDICARE PRESCRIPTION INSURANCE EDUCATION AND INFORMATION
Walgreens is proud to accept most Medicare Prescription Insurance plans. Check with your Walgreens pharmacist to determine if your plan is covered by Walgreens. Walgreens has many services that can benefit those who are signing up for the Medicare Prescription Insurance plan. Including:
- Easy-open prescription bottles.
- Large-type prescription instructions.
- Easy refill options.
Don’t forget, if you are on Medicare Part B, Walgreens has all your diabetes supplies and will bill Medicare directly, with little or no out-of-pocket cost to you. So whether you have a question about your diabetes care, or you need help with Medicare Prescription Insurance, just ask your Walgreens pharmacist. As always, think of the Walgreens team as your partner for health care information about Medicare and other programs. You can read more about Walgreens and Medicare Prescription Insurance on www.walgreens.com/medicare, or ask your pharmacist for a brochure or pamphlet you can take home to learn more.
