A
History on Medicare Reimbursement
Congressman
Farr on Medicare
As you may know, the new
Medicare prescription drug plan took effect January, 2006. Under current law,
if you were eligible to join you had to have signed up by May 15, 2006.
That means, if you were eligible to sign up and did not, your window of
opportunity is closed until "open season" which begins November 15,
2006 and runs until December 31, 2006.
Here are key issues to remember about the new Medicare prescription drug
program:
- If you currently have Medicare Part A (Hospital
Insurance) and/or Medicare Part B (Medical Insurance) you can join a
Medicare prescription drug plan.
- Your coverage will be effective the first day of the
month after the month you join.
- If you do plan to enroll you must do so in month you
become eligible or face a penalty.
- If you sign up for the Medicare drug coverage plan, you
can only have that plan. You cannot in addition also have a separate
Medi-gap plan or a retiree health plan from your place of employment.
- You can join or change plans once each year between
November 15 and December 31 ("open season").
These are
cautionary notes to people who are considering the new Medicare drug plan:
- It does not guarantee a discount on prescriptions.
- Drug companies (not Medicare) determine what drugs have
discounts and how much seniors pay, so costs will vary person to person,
depending on which company you choose.
- Seniors can sign up for only one card, not try to
maximize their savings by using different cards for different drugs.
- The government is prohibited from negotiating for lower
prices for drugs covered under the program.
- The insurance companies set the premiums to be in the
program, determine the drugs they will or will not cover, and at what cost
savings, not Medicare. You may find wide variations in
benefits between different plans.
The Program in California
There are over 40
million Medicare beneficiaries nationwide, and 4,076,000 of them are in California. Of those in California, 933,000
beneficiaries do not have any prescription drug coverage.
California
has a combined total of 47 individual drug cards available, in addition to10
national drug cards.
Seniors are advised to really, really check their options before deciding on
whether or not to enroll in Medicare Part D. Questions can be directed to
the Medicare Hotline at 1-800-MEDICARE (1-800 633-4227) or to the Health
Insurance Counseling & Advocacy Program (HICAP) at 1-800-434-0222. Further
general information can be found on the web at www.medicare.gov.
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