You may have started receiving letters and notices regarding
Medicare’s prescription drug coverage, which will help you pay
for brand name and generic drugs. The voluntary program takes
effect January 1, 2006. It’s important to open, read and
save all coverage notices to ensure you understand the benefits
you are entitled to.
Unfortunately, the program created by the federal government is
tremendously bureaucratic and confusing. To help you find your
way through the maze of regulations, here is some basic
The new Medicare prescription drug program is voluntary.
However, if you have both Medicaid and Medicare you must enroll in a
Medicare prescription drug plan. If you do not pick a plan and enroll
before December 31, 2005, you will be enrolled in one of the new drug
plans automatically because your Medicaid drug benefit will end on
If you have drug coverage (other than Medicaid) now, your
current insurance company has to provide you with a notice
indicating if your current prescription coverage is "as good or
better than" the standard Medicare plan. If it is, you do not have to
consider joining a Medicare plan at this time. Otherwise, you
should consider signing up for a Medicare drug plan between
November 15, 2005 and May 15, 2006 to avoid paying a late
Seniors with EPIC can keep their EPIC coverage. For some,
particularly those eligible for"extra help" for low income
beneficiaries, enrolling in the Medicare drug program will mean
more savings. EPIC will waive fees for low-income enrollees
eligible for full "extra help" who join a Medicare plan.
The new Medicare drug program provides"extra help" to
pay for drug costs for beneficiaries with lower incomes; contact your
local social security office or area agency on aging. Those already
in Medicaid or in one of the Medicare savings programs (QMB, SMB and
QI-1) will be eligible automatically for "extra help."
This new Medicare drug benefit will only be available through
private plans. This means that in order to get prescription drugs
covered through Medicare, New Yorkers must enroll in one of the
plans offering the benefit in New York State. HMOs and other
Medicare Advantage plans will also be offering the new
prescription drug benefit.