Home > Constituent Services > Medicare Prescription Drug Benefits

Open printer-friendly page

Your Medicare Prescription Drug Benefits

Information about the new Medicare Part D Prescription Drug Benefit

As you may know, I opposed the Medicare Modernization Act (MMA) because I believed it created an inadequate and complicated new prescription drug benefit. Beyond that, it produced fundamental changes to the Medicare program that I believe will ultimately hasten its demise. Nevertheless, the bill passed and the Medicare prescription drug benefit (Part D) is being implemented. Depending on your current situation, Part D may help you reduce your prescription drug costs. If you are eligible for this benefit, you have important decisions to make about whether to enroll in Part D, and if so, in what plan. Unfortunately, if you did not enroll by May 15th then you must wait until the next open enrollment period that begins November 15, 2006. Your coverage would then begin January 1, 2007. If you missed the first deadline, you will have to pay a penalty of 1% per month for each month you were eligible but not enrolled. There are some exceptions to the deadline and the penalty. For example, if you have Medicaid and Medicare or if your income makes you eligible for extra help, you should be able to enroll at any time.

I have joined with over 170 of my Democratic colleagues in co-sponsoring legislation that would push the enrollment deadline to the end of the year and eliminate any penalties for this year. The bill would also give beneficiaries the chance to switch plans once at any time this year. Unfortunately, thus far the Republican Leadership has refused to allow a vote on this bill.

Nonetheless, you should still consider your options if you have not already done so. It is important to save materials you receive from the Centers for Medicare and Medicaid Services, such as the 2006 Medicare and You Handbook, and other materials such as information on your current coverage from your union or former employer. These materials can help you decide whether enrolling in the new benefit makes sense for you.

If you are currently enrolled in Medicare and Medicaid, you are a "dual-eligible" and your prescription drug coverage has likely been switched from Medicaid to Medicare. However, you should remember that as a dual-eligible you always have the option to select a different Medicare Part D plan than the one you are currently enrolled in.

Navigating the choices offered by Part D is difficult. The Massachusetts SHINE Program offers counseling and assistance to all Medicare beneficiaries. You can contact them at 1-800-AGE-INFO (1-800-243-4636).

To compare plans and learn more about the Part D benefit, you can also visit www.medicare.gov or call 1-800-Medicare.

–Mike Capuano