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Medicare's Prescription Drug Plans

What does Part D means for you?

Medicare's prescription drug plans (Part D) began January 1, 2006. Everyone covered by Medicare is eligible, regardless of income and resources, health status, or current prescription expenses. Most prescription drugs are covered.

For people already on Medicare, the open enrollment period for 2008 begins on November 15th and ends December 31, 2007. The next open enrollment period begins November 15, 2008 and ends on December 31, 2008.

If you are NOT YET on Medicare, or if you just turned 65, you can apply for a Part D prescription drug benefit at any time beginning 3 months before the month of your 65th birthday, or you can delay your decision for up to 3 months after the month of your 65th birthday. For example, if your 65th birthday is August 20th, you can apply for Part D at any time from May 1st to November 30th without any penalty.

Medicare's Prescription Drug Plans are provided by several insurance companies, HMOs, and other health-related companies. To receive approval from the federal government, each prescription drug plan must meet the following minimum requirements. (Note: The dollar amounts are increased on January 1st every year based on inflation.)

There are several potentially nasty surprises you need to be aware of:

Nasty Surprise #1 — "inflation increases"

The $275 annual deductible, $25 average monthly premium and other coverage amounts described above apply only to 2008. As indicated above, these amounts are adjusted for inflation every year on January 1st. However, copayment amounts for people who are eligible for low-income assistance will not be adjusted for inflation.

Nasty Surprise #2 — "separate enrollment"

Most people must enroll separately for the Plan D prescription drug benefit if you wish to participate, even if you are already enrolled in Medicare Part A and B (the government loves paperwork!).

Nasty Surprise #3 — "freedom of choice"

If you have better prescription drug coverage from your union or employer, or if you qualify for coverage from TRICARE, the VA, or the Federal Employee Health Benefits Program, you do not have to enroll in Medicare's new Part D prescription drug plan until you are no longer eligible to participate in one of those plans.

For everyone else age 65 or older, Medicare's Part D prescription drug plan is voluntary — you don't have to enroll if you don't want to. For many seniors, it might cost more than you could expect to receive in benefits, especially if you are healthy. Or, you might put off enrolling because you simply can't afford it.

But, if you delay enrolling for more than 3 months after you first become eligible, you will be penalized for the rest of your life! The penalty will permanently increase your premium 1% for every month you delay. For example, if you delay 10 months, you will pay 10% more than almost everyone else. If you delay 2 years, your premium will be nearly 25% higher.

— How to Enroll —

If you are already on Medicare, you can join a plan between November 15th and December 31st in the following ways:

By paper application. Contact the company that offers the drug plan you want and ask for an application. After you fill out the form, mail or fax it back to the company.

On the plan's website. Visit the drug plan company's website. You may be able to join online.

On Medicare's website. You can also join a drug plan at www.Medicare.gov by using Medicare's online enrollment center. You can find more information about all of the plans that are available in your area by using Medicare's online tool, the Medicare Prescription Drug Plan Finder.

By calling Medicare. Call 1-800-MEDICARE (1-800-633-4227) and talk to a customer service representative. TTY users should call 1-877-486-2048.

For more information, including a description of people who do not have to enroll in the new Part D benefit, visit the Medicare.gov website.


If you are NOT YET on Medicare, you can apply for the new Part D prescription drug benefit at any time beginning 3 months before the month of your 65th birthday, or you can delay your decision for up to 3 months after the month of your 65th birthday. For example, if your 65th birthday is August 20th, you can apply for Part D at any time from May 1st to November 30th without any penalty.


For more information about Medicare, including how you can contact your local State Health Insurance Assistance Program (SHIP) for more information, visit Medicare's Web site, or call Medicare toll-free at 1-800-633-4227.

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