Medicare Part D Q&A
Beginning January 1, 2006, new Medicare prescription drug plans (Part D) will be available to people with Medicare.
Q: What are Medicare prescription drug plans?
A: Medicare prescription drug plans provide insurance coverage for prescription drugs. Insurance companies and other private companies work with Medicare to offer the Medicare Prescription drug plans. Like other insurance, if you join you will pay a monthly premium (generally about $24 in 2007) and pay a coinsurance for your prescriptions. Costs vary depending upon which drug plan you choose.
Q: Who is eligible for Part D?
A: Anyone entitled to Medicare Part A or enrolled in Medicare Part B is eligible for the Medicare Prescription drug coverage. You cannot be denied coverage. Participation is voluntary.
Q: Are all plans the same?
A: Medicare will contract with private companies to offer prescription drug plans. You will have a choice of plans to select from. Drug plans may vary in what prescription drugs are covered, how much you have to pay, and which pharmacies you can use. All drug plans will have to provide at least a standard level of coverage, which Medicare will set. However, some drug plans might offer more coverage and additional drugs for a higher monthly premium. When you join a drug plan, it is important for you to choose one that meets your prescription drug needs.
Q: Do I have to participate?
A: Participation is voluntary. However, like other types of coverage, premiums may increase the longer you wait. If you choose not to enroll now and later change your mind, you may have to pay higher premiums due to a late enrollment fee. The late enrollment fee is one percent per month.
Q: When will Medicare prescription drug plan information be available for enrollment?
A: Enrollment information from companies offering Medicare prescription drug plans is available as of October 1st.
Q: What coverage does the Medicare Prescription drug plan provide?
A: Plans will vary, but generally they will have:
- A $265 annual deductible
- For charges between $265 and $2,400 the government would cover 75% of the costs of prescription drugs, and you would be responsible for the remaining 25%.
- For charges between $2,400.01 and $5,451.25, you would be responsible for 100% of all charges
- And for charges over $5,451.25 the government would pay 95% of charges and you would be responsible for the remaining 5%.
Q: What if I already have prescription drug plan coverage on my Medicare Supplement plan?
A: If you have a Medicare Supplement plan with prescription drug coverage, you will be sent a notice by November 15th each year explaining your rights and choices. If you are happy with your current coverage, and wish to remain in your current plan, you are not required to take any action.
Q: How much does a Medicare Prescription drug plan cost?
A: Participation is at a cost. The average cost is expected to be around $24 per month for 2007. This is the amount the Medicare beneficiary pays. In addition, the government will contribute toward the cost for (a subsidy paid to the private company offering the plan). In future years costs may go up. Deductibles and co-pays or coinsurance amounts are also subject to change from year to year as are the plans and companies offering coverage.
Q: How can I get help in choosing a Medicare prescription drug plan?
A: You will be able to get personalized information at www.medicare.gov on the web, or by calling 1-800 MEDICARE (1-800-633-4227) to help you make your best choice. TTY users should call 1-877-486- 2048. Your State Health Insurance Assistance Program (SHIP), and other local and community-based organizations will also provide you with free insurance counseling.
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