FAQs

Who can join?

When can I join?

How much does it cost?

When can I get more information?


LINKS
Medicare

PACE & PACENET

APPRISE

AARP

Part D and Me
Low-Income Subsidy Application and Tools
Fact Sheets for People with Medicare
Medicare Rx Education Network
National Council on Aging


KEY DATES

Fall 2005
Beneficiaries receive information in the mail about the new drug benefit

November 15
Enrollment for Medicare Prescription Drug Plan begins

January 1, 2006
Coverage available for all people in Medicare

Over the years, Medicare has offered relief to millions of seniors in need of health care. But in recent years, it has become obvious that Medicare simply cannot sustain the demands we are placing on it; reform is necessary.

On December 1, 2003, President Bush signed into law the first major overhaul of the Medicare program since its inception in 1965. While not perfect, this bill made major changes to your Medicare coverage.

In 2006, the Prescription Drug Benefit will be added to Medicare. All people with Medicare will be able to enroll in plans that cover prescription drugs.

People with Medicare will pay a premium estimated to be $35 a month and there will be a $250 deductible. Medicare will pay 75% of drug costs between the deductible and $2250. Medicare then pays 95% of drug cost above $5100. The Prescription Drug Benefit includes additional assistance for people with low income and limited assets.

Most significantly, people with Medicare who are also fully eligible for Medicaid with incomes below 100% of the federal poverty level (and with no separate asset test) will receive:

  • Full premium subsidy
  • Full subsidy of deductible
  • Minimal co-pays

Other beneficiaries with low income and limited assets will receive premium and deductible assistance and have limited cost sharing.

Who can join?
Anyone with Medicare Part A and/or Part B can join a Medicare prescription drug plan offered in their area. If you are in a Medicare Advantage Plan (like an HMO or PPO), your plan may also offer drug coverage.

When can I join?
If you currently have Medicare Part A and/or Part B, you can join a Medicare prescription drug plan between November 15, 2005 and May 15, 2006. If you join by December 31, 2005, your Medicare prescription drug plan coverage will begin on January 1, 2006, and you won’t miss a day of coverage. If you join after that, your coverage will be effective the first day of the month after the month you join. If you join a Medicare prescription drug plan after May 15, 2006, you are likely to pay a higher monthly premium unless you currently have a drug plan that covers at least as much as a Medicare prescription drug plan. You will have to pay this higher premium as long as you have a Medicare prescription drug plan.

How much does it cost?
Like other insurance, if you join, you will pay a monthly premium (generally around $37 in 2006) and a yearly deductible (up to $250 in 2006). You will also pay a part of the cost for your prescriptions, including a copayment or coinsurance. Costs will vary depending on which drug plan you choose. Some plans may offer more coverage and additional drugs for a higher monthly premium. If you have limited income and resources, and qualify for extra help, you may not have to pay a premium or deductible.

When can I get more information?
Detailed information about Medicare prescription drug plans in your area will be available in the fall of 2005. Throughout 2005, Medicare will provide general information to help you get ready, including how to choose and join a plan that meets your needs. In the fall of 2005,

  • you will get the "Medicare & You 2006" handbook in the mail.  It will list the Medicare prescription drug plans available in your area.
  • you will be able to get free personalized information at www.medicare.gov on the web, or by calling 1-800-MEDICARE (1-800-633-4227) to help you choose the plan that meets your needs.
  • you can get free personalized counseling from your State Health Insurance Assistance Program (SHIP), and other local and community-based organizations. Call 1-800-MEDICARE to get the telephone number of the SHIP nearest you.

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