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What’s the deal with Medicare D?
If you really want to impress your friends or family, the next time you see them, drop this comment: “I sure hope they’ll decide my retiree health insurance is actuarially equivalent to Medicare D or I’ve got a real problem on my hands.” The reaction most likely will be, "What’s that you say?"
Approximately 90 percent of the elder population has never heard about Medicare Part D. Approximately 99.9 percent of the general population has never heard of it either. Is there a test on this? Sort of, and it will be given beginning this fall and will be a “take home exam” that you have until December 31st to complete. (If you are lucky, you’ll get an extension to May 15, 2006!)
Now you’re not only totally confused, but you’re also anxiety-ridden! Welcome to the world of prescription drug coverage.
Let’s take it one question at a time.
Q. What IS Medicare Part D? I have enough trouble keeping up with A & B!
A. Medicare Part D is a new Prescription Drug program that will be inaugurated on January 1, 2006. For most people, a premium will be deducted from their Social Security checks. If you do not have prescription coverage now, you are encouraged to enroll in Part D because a delay in enrollment could mean that you pay a premium penalty for enrolling later on.
Q. I don’t have ANY prescription drug coverage, and I’m a Medicare beneficiary. Is Medicare D going to be helpful to me?
A.Yes. You will have at least some coverage for prescription drugs. There are premiums, co-payments, and deductibles. However, for relatively low-income individuals there will be assistance in paying premiums and co-payments, and there will be fewer gaps in coverage.
Q. I’m on Prescription Advantage. Do I also have to join Medicare D?
A. Yes. Your Prescription Advantage membership will entitle you to some extra assistance with some of the ‘gaps’ in Medicare D. It’s not clear what that assistance will look like, but it will be helpful to you.
Q. I’ve always wanted to join Prescription Advantage, but I don’t ever seem to think about it when it’s open enrollment time. Can I join during an open enrollment this year?
A. We don’t know! Keep calling Elder Services and reading Berkshire Senior to make sure you’re up to date with any new information. Write to your state legislators and ask them to provide an open enrollment this year.
Q. I’ve never heard of Prescription Advantage, but I don’t have any prescription drug coverage and I’m over 66. What should I do?
A. See answer #3 above. If you’re about to turn 65, or haven’t yet turned 66, please call Elder Services IMMEDIATELY to get more information (1-800-544-5242 or 413-499-0524).
Q. I’m one of those lucky people who don’t have to think about prescription drug coverage. I have insurance through my retirement plan. How should I spend the $35 per month that won’t be taken out of my Social Security check?
A. Before you spend the money, wait for your former employer to let you know that it intends to continue your prescription drug coverage. A letter should arrive this summer which will let you know whether you need to sign up for Medicare Part D or not. If you don’t get a letter, or feel like you’re getting conflicting information, call Elder Services.
Q. I am on MassHealth. Will I have $35 deducted from my Social Security check to pay for my prescriptions?
A. No. You will receive information on your prescription drug plans this summer and fall. You will still have low co-payments. Keep in touch with Elder Services to be sure that you are enrolled in the plan that’s best for you.
Q. I don’t think I fit into any category you’ve already mentioned! What should I do?
A. Call Elder Services' SHINE (Serving Health Information Needs of Elders) Program at 1-800-544-5242 or 413-499-0524 and ask as many questions as you want. Call your local Council on Aging and ask them when Elder Services will be coming to visit your community. Call your local library and ask them if they’d like to host an information session this summer about Medicare D. Call any elders you know and make sure that they understand how the changes in Medicare will affect them. Call your children and make sure they’re aware that elders are going to have to make choices and you need them to be standing by in case you need advice.
SHINE Program staff are ready to answer any questions that Medicare beneficiaries have about coverage, gaps, benefits and claims, so feel free to call your local Council on Aging or Elder Services for assistance.
Attention: Medicare Beneficiaries
Do you now have $78.20 a month deducted from your Social Security check for Medicare Part B?
If you are a single individual with an income less than $12, 924
with less than $4,000 in savings and assets
or
A couple with a joint income less than $17,328 with less than
$6,000 in assets, We can assist you in applying for help
with your Part B premium.
Please contact Elder Services’ SHINE (Serving the Health Information Needs of Elders) program — 1-800-544-5242 or 413-499-0524.
Individuals and couples with slightly higher asset levels will be eligible for extra financial assistance with the new Medicare D premiums.
For screening & application assistance, call SHINE or your local Council on Aging.