CONSTITUENT SERVICES » Medicare/ Prescription Drugs
Medicare's New Prescription Drug Program
Medicare began prescription drug coverage on January 1, 2006. - Medicare pays for both brand name and generic drugs.
- Medicare prescription drug coverage is optional, and totally voluntary.
- Medicare provides extra help for those who qualify through the Social Security Administration or the state.
- Everyone with Medicare is eligible regardless of income level, resources, pre-
existing conditions, or current prescription expenses. - There are two types of Medicare prescription drug plans:
- Additional coverage to the original Medicare fee for service plan;
- Coverage that is a part of Medicare Advantage Health Plans
(ex. HMOs, PPOs; PFFSs)
Extra Help
- You automatically qualify for extra help if you have both Medicare and Medicaid, both Medicare and Supplemental Security Income (SSI), or both Medicare and a Medicare Savings Program.
- You can also qualify for extra help if your annual income is below $14,355 for a single person or $19,245 for a married couple, and if your resources are less than $11,500 for a single person or $23,000 for a married couple.
- Apply for this extra help through the Social Security Administration.
Medigap
- If you have a Medigap policy, you will need to make some decisions. It is your choice to enroll in a Medicare prescription drug plan.
- What you need to know:
- Medicare will give you at least two plans to choose from in your area.
- Please note that you cannot have prescription drug coverage under both a Medigap policy and a Medicare prescription drug plan at the same time.
- You have four options:
- Enroll in a Medicare prescription drug plan and keep the Medigap policy without the prescription drug coverage.
- Enroll in a Medicare prescription drug plan by May 15, 2006, and you can switch from your current Medigap policy to one that does not include prescription drug coverage.
- Enroll in an HMO, PPO or PFFS that offers prescription drug coverage. Therefore, you will not need a Medigap policy.
- Keep the Medigap policy that you currently have.
For more information, call 1-800-MEDICARE or visit www.medicare.gov. For assistance on deciding which plan best meets your needs, call the Health Information, Counseling and Advocacy Program (HICAP) at 1-800-252-9240.
