Medicare Prescription Drug Update

Starting January 1, 2006, Medicare will offer a prescription drug benefit through a variety of private drug plans. This new benefit, called Medicare Part D, is the most sweeping change to Medicare in decades.

For some, this new program may be helpful and provide seniors with a benefit that they do not currently have. But for many, it will present a wide and potentially confusing array of options.

I do not believe that this benefit is the best method to provide prescription drug coverage. The bill did virtually nothing to lower actual drug prices and expressly prohibits the government from using the large number of Medicare beneficiaries to negotiate lower prescription prices with drug companies. In addition, there is a significant gap in coverage, which is referred to as "the doughnut hole."

I did not vote for this plan because of these concerns. However, I am committed to providing seniors with the best available information so they can get the most of this benefit.

Although coverage will not begin until January 2006, there are a number of critical dates to be aware of between now and then.

First, it is important to know that this new prescription drug benefit is available to all Medicare beneficiaries. Also, it is a voluntary program, so beneficiaries can decide not to sign up for it. However, if one does not sign up during the initial open enrollment period and then signs up later, the beneficiary may face a penalty.

Even if one currently has prescription drug coverage through a Medicare HMO, a Medigap policy, or through a retiree plan, they will be receiving information in the mail regarding coverage and options. Medicare beneficiaries may need to determine whether or not their coverage is adequate and whether they should sign up for a Medicare Part D plan. Insurers have until November 14, 2005 to send out notices to all policyholders.

Information about the new Medicare prescription drug plans is now available at www.medicare.gov or by calling 1-800-Medicare. In addition, the Medicare & You 2006 Handbook containing all the necessary information will be mailed to all Medicare households beginning in October. Many households have already begun receiving these books. Medicare recipients who have not received a handbook can go to Medicare's Web site or call the 800 number listed above.

Initial enrollment in Medicare prescription drug plans begins on November 15, 2005. The open enrollment period ends May 15, 2006. Remember, enrollment is voluntary, but those who choose not to enroll by May 15 may face a penalty if they change their minds later.

Medicare beneficiaries with low-incomes may qualify for additional assistance to pay for their prescription drugs. This extra help is called the “low-income subsidy” and is available to those who meet the income and asset qualifications. Some low-income beneficiaries, for example people receiving Medi-Cal, will be automatically enrolled in the low-income subsidy program, however, they will still need to choose a specific drug plan.

The Social Security Administration (SSA) is the agency that will be processing applications for the low-income subsidy. If you think you might be eligible or if you need information, please call the SSA at (800) 772-1213, or visit their web site at www.socialsecurity.gov. You are not obligated to sign up for a drug plan if you qualify for additional assistance.

There are also some resources in San Diego that can help Medicare beneficiaries understand the various options. The Health Insurance Counseling and Advocacy Program (HICAP) can be reached at (858) 565-8772. The Consumer Center for Health Education and Advocacy can be reached at (877) 734-3258. You can also learn more by going to www.medicare.gov.

If you would like more information or have any questions regarding the new Medicare prescription drug plan, please feel free to call my office at (619) 280-5353.

                                                          

*Note: You will need Adobe Acrobat Reader to open some of the following documents.

Read My Statements on the Medicare Bill

Explanation of My Vote

Congressional Record Statement

Floor Statement on the Medicare Conference Report and its Impact on Older women

Use the Drug Spending Calculator to find out how this bill could affect you!  

Calculate your prescription drugs costs, based on the tentative conference committee proposal

What Does the Medicare Bill Mean for Me?

How the Medicare Bill Affects Older Women

Understanding the New Medicare Prescription Drug Benefit

Charts

Side-by-Side of House Bill, Senate Bill and Conference Report

Comparison of Medicare Bills by Ways and Means Committee

How Big is the "Donut Hole"?

Studies & Reports

GAO Study Shows Prescription Drug Cards Fail to Provide Meaningful Savings to Seniors

Also, read the GAO Press Release here.

Medicare Agreement Could Cause Hardship for Many Poor Seniors and Disabled People

The Troubling Medicare Drug Agreement

National and State Impacts of the Medicare Prescription Drug Conference Report

AARP

AARP Items of Concern and the Medicare Bill

AARP’s Conflict of Interest in the Medicare Drug Bill