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August 2005 Back to Table of Contents Back to Archives Main Page Section: Being Well Medicare Part D - A Quick Look By Toby Laping, Ph. D., C.S.W., Private Care Manager
I am not an expert on this program, but it’s clear that knowledge about some basics is essential. Do not throw away letters you receive about this unopened. They’re too important not to read. Also read the many articles that are found in magazines and newspapers. This program begins January 1, 2006. Participation is not mandatory; enrolling is optional although there may be a premium penalty if you delay enrollment until after May 15, 2006. Drugs will not come directly from Medicare. Instead, their costs will be covered by the drug program for which you sign up, if, in fact, you choose to sign up. Getting good drug coverage is very hard, particularly if you aren’t a member of a group that provides medication benefits. Whether Medicare’s Part D provides good coverage is debatable and that’s why you must do your homework. Most people will pay a monthly fee, which is expected to average around $37 a month, in addition to paying part of the cost of prescription drugs and an annual deductible amount. There is a low income subsidy for low income people who are not on Medicaid. There are issues you need to be aware of. For example, once you sign up with a drug plan, you can only change plans once a year. On the other hand, the plans can change the drugs they provide as long as they give you 60 days notice. You could pick a company based on the fact that it lists all the drugs you’re taking, only to find out that they’ve dropped one or more of your drugs. Plans must cover at least two drugs of each type of drug class but sometimes health care providers want very specific manufacturers of drugs. You can appeal but you may not be satisfied with the outcome. People who are enrolled in both Medicare and Medicaid will need to choose a drug plan no later than January 1, 2006. You ought to receive information from Medicaid about your choices. If you don’t make a selection, you will probably be randomly assigned to a drug program. Being passive is not a particularly good idea though, because you might be assigned to a drug program that doesn’t carry your medications. Instead, enroll in November of this year so you can get your card in December. To learn more, call 1-800-MEDICARE (1-800-63342273). Think carefully about the decision you make regarding a drug plan. In the meantime, if you are low or moderate income, you should be enrolled in New York State’s very helpful drug benefit program, EPIC, which is known to every pharmacist. Applications are available at drug stores. www.wnycaremanager.com back to top back to table of contents Current Issue | About Forever Young | Where to Find | Advertise | Our Advertisers | Community Calendar | Contest | Clubs | Contact Us | Archives | Home |
