Show #324 Airing Sunday, 1/1/06
It’s finally here! Medicare Part D Drug coverage starts today. If you’ve been watching Golden Opportunities, and I hope you have, you know more than most folks about this complicated program. But you may still have questions. So we’ve invited the maven of Medicare, Dr. Alice Petrulis, medical director for Ohio kePRO, to join us.
Question: We’ve talked about Medicare’s new prescription drug plan several times on the show, but there’s so much to cover…and it can be confusing. Is there a place people can go to get answers to their questions?
Answer: You can always call 1-800-Medicare and ask to speak to someone. Or you can go on their website, www.medicare.gov. If you click on “Frequently Asked Questions” at the top, it brings you to a page of general Medicare questions. Choose “Medicare Prescription Drug Coverage” from the drop down menu, and the questions—and answers—will focus in on that.
Question: Let’s go through some of the more common ones here today. First, How do you join a Medicare Prescription Drug Plan?
Answer: You can use the same medicare.gov website. Click on “Medicare Prescription Drug Plan Finder” and register for the program online.
You can call the company who is offering the drug plan you choose and fill out a paper application.
You can visit the drug plan company’s website and see if you can register online there.
Question: Next, do you have to join a Medicare drug plan?
Answer: No. Joining a Medicare drug plan is your choice. However, if you do not join by May 15th, you will have to wait until November 15th, and there will be a penalty in the form of a higher premium.
If you currently have drug coverage through an employer or a former employer, you should be receiving a letter stating that this coverage is as good as or better than those of the Medicare drug plans. Hang on to this letter. If there comes a time later when you lose coverage, this letter will help you avoid the higher premium penalty for a late sign-up for the Medicare plans.
Question: Should you join a Medicare drug plan even if you don't take many prescription drugs?
Answer: You should still consider joining a Medicare drug plan now. It is likely, as you get older, that you will need the plan. Sign up now and you’ll have a lower premium.
Question: Is there information and help available to compare Medicare drug plans?
Answer: You should have received a handbook in the mail this past fall entitled “Medicare & You 2006.”
You can use the Medicare Prescription Drug Plan Finder link on the medicare.gov website.
Or you can call 1-800-Medicare and ask for the information.
Question: Next, when and how often can you switch your Medicare drug plan?
Answer: Generally, you can choose to switch your current plan from November 15 through December 31 of every year. Enrollment is for the calendar year.
There are exceptions if you move (you may move to an area with different plans available) or if you enter a nursing home.
If you have both Medicare and Medicaid, you can switch at any time.
Question: Do all the plans cover all drugs?
Answer: No. You must pick the plan that covers all or most of your medications. Go to the Medicare website, www.medicare.gov, or call 1-800-medicare. Then go to a “Compare Medicare Prescription Drug Plan,” compare plans, pick the best for you.
Question: Can the plan later drop coverage for one or more of my drugs?
Answer: Yes. They must give 60 days notice. If they drop your drugs, you may change plans without penalty. But you generally may not do so until November 15 th.
Question: What should people do who are in a Medicare Advantage Plan, like an HMO or PPO?
Answer: If you have drug coverage already, you should get a letter from the plan telling you about your choices. You can stay in the plan if you wish and continue to get your drug coverage from the plan—it may even get better!
Or you can switch to another Medicare Advantage Plan with better drug coverage.
Or you can go back to regular Medicare and join a prescription drug plan.
Question: What if you get drug coverage from the VA or Tricare?
Answer: In most cases you should stay with that coverage. Anyone to ask at VA for advice?
Question: What if you have Medigap Policy (H, I or J) that covers drugs?
Answer: You can’t buy new Medigap policies that cover prescription drugs.
If you have a Medigap policy with drug coverage, you can keep it, but your current Medigap policy most likely is not as good as the plans available now under Medicare Part D.
If you switch to a new Part D plan after May 15 th, you’ll pay a penalty.
Have we answered your questions? If not, we have a number to call so you can get the answers you need. My thanks to Dr. Alice Petrulis.
