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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 to
which you are entitled.
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
information:
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 that date.
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
enrollment penalty.
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 on 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.
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