Financial Issues
Return to Q&A Library Medicare Part D
Medicare Prescription Drug Plan
Medicare Part D?
What do I need to know about Medicare Part D?
The AA&MDSIF has spoken with many of you who have questions about Medicare Part D—Prescription Drug Coverage. To be honest, we are struggling to understand it as well! Keep in mind that there isn't much about the new Medicare that can be generalized. The decisions you make about the prescription drug plan you choose, if any, are going to be very specific to you and your needs.
- Get assistance from your local Office of Aging. Our local county office is making appointments with individuals to review their needs and help them with the process.
- Ask your pharmacy for a list of the drugs you have taken in the last year. Compare it to the formularies of each company offering coverage in your state.
- Watch the newspapers for talks about Medicare being given in your community—attend and ask questions or have someone attend on your behalf.
- Ask your children for help with gathering information and understanding the issues.
- Choose your sources of information wisely. By one estimate, there are a substantial number of errors on Medicare's website. Call the plans you are interested in directly to verify which drugs they cover and determine the co-payments for your medications.
Generally, it is wise to choose a drug plan that allows you to keep your Part B Medicare coverage. Part B covers doctor's visits. If, for instance, you get growth factor injections like Procrit(R) or Neupogen(R) in your doctor's office, those are covered under Part B (minus your co-payment).
Medicare is now subsidizing employers' drug plans. So, those plans now must provide coverage that is as good as Medicare, but they don't have to be better than Medicare. This may mean that your employer-provided plan will change at some point.
Medicare Prescription Drug Plan*
I meant to sign up for a Medicare prescription drug plan, but it turns out I signed up for a Medicare PPO for basic benefits and drug coverage by mistake. I want to be in regular Medicare for my basic benefits, rather than a PPO. What do I do?
With so many plans available to people on Medicare this year, it is certainly easy to make a mistake like this. Many of the companies that offer Medicare prescription drug plans are also offering other types of Medicare plans, such as HMOs and PPOs. As your experience shows, this can sometimes be confusing.
Fortunately, you can make a change, if you think you've made a mistake. You can disenroll from the particular Medicare PPO that you've selected in one of three ways:
- Send a signed written letter by mail or fax to your PPO requesting to be disenrolled;
- Visit your PPO's website and disenroll online (if the organization offers this option); or,
- Call 1.800.MEDICARE and ask to be disenrolled from your PPO.
You can disenroll from this PPO anytime between now and May 15. After you submit your request, you will be disenrolled by the first day of the following month and covered under the traditional Medicare program from that point forward.
As for your drug coverage, you might want to research Medicare prescription drug plans before disenrolling from your PPO and sign up for a plan that will help cover your drug expenses. If you sign up in the same month as you disenroll from your PPO, your drug coverage will begin the first of the following month, so you won't have a gap in coverage. It is important to note that if you drop your PPO and pick up a drug-only plan, you will not be able to make any more changes to your drug coverage for 2006.
* From: Medicare Q&A Weekly Column, The Henry J. Kaiser Family Foundation, www.kff.org. The information in Q&A: Medicare Prescription Drug Plan was reprinted with permission from the Henry J. Kaiser Family Foundation. The Kaiser Family Foundation, based in Menlo Park, California, is a nonprofit, independent national health care philanthropy and is not associated with Kaiser Permanente or Kaiser Industries.
