Choosing the Right Plan for Your Medicare Part D Prescription Drug Coverage - December 20, 2005
Madison – For Wisconsin’s 844,000 Medicare beneficiaries, the program’s new prescription drug coverage will mean big changes in their health care options.
Medicare’s prescription drug coverage, also known as Medicare Part D, officially gets going on January 1, 2006, and it will be available to everyone who’s already enrolled in Medicare.
Prescription drug coverage under Medicare Part D will be offered by private companies. While each plan will have to satisfy basic Medicare requirements, each plan will also be different. It will be up to each beneficiary to figure out which plan best meets his or her own needs.
“There are some straightforward things that everyone can do to make the choices clearer,” says AARP Wisconsin’s Lisa Lamkins. “The best thing to do is to get all these things written down. For a lot of people, having a written list that includes current insurance, current drug needs, and so on will be enough to be able to make a good decision about choosing a plan. But having a written list will also make it easier to identify questions that you need to find answers for before you make that choice. There are organizations and agencies in Wisconsin that are set up with accurate, up-to-the-minute information to provide those answers.”
Here are the steps that AARP’s Lamkins recommends everyone follow in order to be able to compare Medicare Part D prescription drug coverage plans:
Step 1
What kinds of drug coverage do you have now? How much does the coverage cost you?
While many people have no prescription drug coverage at all, many others are getting some help. These resources include: Medicaid (Forward Card); SeniorCare Rx; Medicare Supplement Insurance (Medigap) with drug coverage; Medicare Supplement Insurance (Medigap) without drug coverage; Veterans Benefits; TRICARE for Life (military retirees); Retiree health and/or drug coverage from Medicare Managed Care (Medicare HMO or PPO, etc.).
If you do have coverage, you should also write down how much you’re currently paying as a monthly premium.
If you have prescription drug coverage via Medicaid’s Forward Card, your coverage will be changing. Beginning January 1, 2006, your prescription drugs will be provided by Medicare. You will automatically be enrolled in a Medicare Part D prescription drug plan.
If the kind of prescription drug coverage you have isn’t one of those listed above, just write down ‘Other’ on your list.
Step 2
Which prescription drugs are you taking? How much do you pay for them at the pharmacy?
In order to get a detailed, personalized comparison of Medicare prescription drug plans, you’ll need to list the drugs you’re currently taking. When you write this out, be sure to include the dosage (How many milligrams?) and the frequency (How many times a day?) as well as the name of the drug itself.
You should also write down how much you’re currently paying for your drugs. If you don’t have coverage, you’re probably paying the regular retail price. If you do have coverage and the drug is covered by your plan, write down how much each copayment is.
You should also think about which pharmacy you buy your prescriptions and whether you’d be willing to switch to a different pharmacy. If there’s a pharmacy that you’d prefer to continue using, write down its name and address next to the list of prescription drugs that you’re taking.
Do you live in Wisconsin twelve months a year? Or do you travel frequently? If you travel frequently, you might consider either a plan that has a mail-order option so your drugs can be mailed to you or a national plan that offers coverage anywhere in the country.
Step 3
Which Medicare prescription drug plans are available in your area?
You’ll be able to make a toll-free call to get this information, either from AARP Wisconsin (1-866-448-3611) or from Medicare (1-800-633-4227).
Step 4
Get detailed information on the Medicare prescription drug plans available in your area.
If you have access to a computer, go to www.medicare.gov and click on ‘Medicare Prescription Drug Finder.’ You can find out which plans will cover the drugs you take, which pharmacies accept which plans, and how much each plan charges as its premium, deductible, and copayments.
The same information is also available if you call Medicare, toll-free, at 1-800-633-4227 and ask for a plan comparison. Medicare will mail you printed comparisons of the plans available in your area.
You can also contact your county Benefit Specialist through your county’s Department on Aging and ask for additional assistance.
Step 5
Compare each Medicare Prescription Drug Plan based on what is important to you.
Compare what each plan available in your area offers in order to find the one that could best meet your needs.
Step 6
Decide if you want to enroll in any Medicare Prescription Drug plan. If you do, use the information you’ve gathered to choose the plan that best meets your needs.
Remember that enrollment in a Medicare Prescription Drug plan is voluntary. If you do decide to enroll, you can enroll directly with the company offering the plan that you’ve chosen. You can also enroll by going to the Online Enrollment Center at www.medicare.gov or by calling 1-800-Medicare (1-800-633-4227).
Step 7
Find out if you are eligible for extra help.
Extra help is available for people with limited incomes and assets (resources). Extra help can assist you in paying for your Medicare prescription drug plan premiums, deductibles, and copayments.
If your annual income is below $14,355 (individual) or $19,245 (couple), you may qualify for extra help. Your assets (resources) must also be less than $11,500 (individual) or $23,000 (couple) for you to be eligible for extra help.
For more information on extra help or to request an application form, contact the Social Security Administration toll-free at 1-800-772-1213 or at www.socialsecurity.gov online.