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
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 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.
|