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Top 10 things to know about Medicare Part D

This is a good place to start to learn about Medicare Part D if you don't have much time yet or just want a quick overview. Later you should get more details. So the Top 10 things to Know about Part D are...

 

  1. Medicare Part D is the new prescription drug program available to all people eligible for Medicare (that is, anyone who has Medicare Part A and/or Part B) beginning January 1, 2006. Its benefits can include saving you money today as well being your insurance policy for the future.
     
  2. Medicare Part D is optional for everyone (except it is mandatory for people receiving Medicaid in addition to Medicare; more on that later). After researching the available Part D Plans, you might decide that Medicare Part D is not worth the monthly premium that it will cost you. But you should be careful: missing your first opportunity to join could cost you more money. Plus, there is financial assistance available to people with limited income and resources.
     
  3. You must enroll in a particular Medicare Part D Plan. That's right, you will only get the benefits of Medicare Part D if you take action and sign up for a particular plan. Medicare is doing its best to make this easy, and is providing program information to eligible participants in fall 2005. For a very few people, a Plan will be selected for them if they don't make a choice, although they can still change plans later.
     
  4. Medicare Part D will be available for a monthly premium you will pay from a variety of private companies over a six-month open-enrollment period beginning November 15, 2005 and ending May 15, 2006.
     
  5. You will have choices in plans. Medicare Part D Plans must meet the government's basic requirements but Plans will vary based on cost, which prescription drugs are covered, and pharmacies that may be used. Compare the plans to find the one right for you.
     
  6. Medicare Part D works with Medicare Parts A and B. Or, you can sign up with a Medicare Advantage plan tha offers a Part D Prescription Drug Plan. Individuals entitled to Part A or enrolled in Part B can receive help paying for prescription drugs. In general, Medicare Part D will become more beneficial to the enrollee as prescription drug costs increase. (In case you're wondering, Medicare Part C referred to the Medicare+Choice plans, which are now known as Medicare Advantage.) Also, note that under Medicare Part D, when you use the plan's network pharmacies, you can purchase prescriptions at discounted prices negotiated by the plans with the drug companies. So, when you pay for drugs within the Prescription Drug Plan, you will benefit from discounted prices even when you are responsible for paying some or all of the cost under the Plan. 
     
  7. Assistance is available for individuals with limited income and resources can get financial help for Medicare Part D, including no monthly premiums, no deductibles and no gap in coverage for qualified individuals. Click here if your individual annual income is below $9,570.  
     
  8. Individuals who are enrolled in both Medicare and Medicaid ("Dual Eligibles") who have not already selected a Part D plan will be automatically enrolled in Medicare Part D by their state agency in the fall. This also applies to nursing home residents receiving Medicaid.
     
  9. Eligible individuals who choose not to enroll during the initial open-enrollment period (November 15, 2005-May 15, 2006) may enroll from November 15 and December 31 of each subsequent year, but penalties will apply.
     
  10. Enrollees can change their qualified prescription drug coverage plan any time through June 30 of 2006. From July 1 through December 31, they cannot change plans. For subsequent years, enrollees will be able to change their plan from November 15 to December 31 of each year to be implemented on January 1 of the following year. For example, starting November 15, 2006 you can sign up for a new plan to be effective January 1, 2007.