Medicare Prescription Drug Coverage
What if I can’t pay the premiums or deductibles for Medicare prescription drug coverage? Where can I get more information? How does the plan work?Everyone on Medicare will be able to sign up for Medicare drug coverage. There will be different plans to choose from. For a list of the plans in Arkansas, go to www.medicare.gov or call 1-800-MEDICARE (1-800-633-4227). The 2006 Medicare & You handbook also has the information. Insurance companies and other private companies work with Medicare to offer the new drug plans. They are different from the Medicare-approved drug discount cards that you may have gotten last year. You cannot use the discount cards after May 15, 2006, or any time after you sign up for the Medicare drug plan. How much will it cost?How much you pay depends on the plan you sign up for or if you qualify for extra help. (See the next question to see if you qualify.) For a standard plan, you will pay a monthly premium (an average of $32.20 for 2006) and a yearly deductible ($250 in 2006). Once the deductible is met, Medicare pays 75 percent of drug costs up to $2,000. You would pay the other 25 percent (or $500). After that, you have to pay 100 percent for each of your prescriptions until you have paid $2,850. The total amount will be $3,600 if you also count the yearly deductible and the original $500. Then, Medicare pays 95 percent of drug costs for the rest of the year and you pay five percent. What if I can’t pay the premiums or deductibles for Medicare prescription drug coverage?Some people can get extra help paying for Medicare drug coverage premiums and deductibles. The application for extra help comes from the Social Security Administration. You must have limited income (below $14,355 for a single person or below $19,245 for a married couple). You must also have limited resources (less than $11,500 for a single person and less than $23,000 for a married couple). The 2006 Medicare & You handbook incorrectly states that if your income is low enough to qualify for the extra help, all the drug plans are available to you with no monthly premium. Only some of them will not have the monthly premium. If you did not receive an application and think you might be eligible, go to www.socialsecurity.gov. You can also call 1-800-772-1213 (TTY 1-800-325-0778) for a paper copy. You automatically qualify for extra help (and do not have to fill out an application) if:
If you have Medicare and the state pays for your Medicare premiums (or if you have applied and qualify for the extra help), CMS will give you until May 15, 2006, to enroll in a plan of your choice. If you don’t choose one by then, they will enroll you in a plan and your coverage would begin June 1, 2006. When do I need to sign up?You can sign up for a Medicare drug plan starting on Nov. 15, 2005. If you sign up between Nov. 15 and Dec. 31, 2005, your Medicare drug coverage will begin on Jan. 1, 2006. If you sign up between Jan. 1, 2006, and May 15, 2006, coverage will begin on the first day of the month after you joined. It’s better to sign up as soon as you are first eligible because you may have to pay more for coverage later on. If you become eligible for Medicare after January 2006, you can enroll in a drug plan:
How should I choose my plan?To choose your plan, think about how much you pay for medicines right now. Then, compare it to one of the Medicare drug plans. Keep a list of the name and dosage of the prescriptions you use. This will help you choose a plan that meets your needs. If your current plan covers as much as (or more than) a Medicare drug plan, you have “creditable” coverage. You can keep your current plan and sign up for the Medicare plan later. In this case, your premium will not be higher because you waited. Where can I get more information?You can get personalized information at www.medicare.gov or 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048. Arkansas’ State Health Insurance and Information Program (SHIIP) (1-800-224-6330) can also help. |
 |
