October 13, 2006, Newsletter Issue #74: Medication Coverage Under Medicare Part D

Tip of the Week

Medicare Part D outlines the minimum requirements for prescription drug coverage plan, provided by private insurance companies.



If you have prior prescription drug coverage, your providing company is required to notify you whether their coverage is equal to or better than Medicare D. If their coverage does not meet the minimum standard you may need to sign up for Part D drug plan.



Here are key considerations when choosing a Medicare Part D Prescription Drug Plan:



1. Does the plan cover the prescription

medications that you take?



Each Plan has a formulary - a list of

medications that they will cover, at

varying costs. Before you sign up for a

Part D plan, you need to check your

medications against the formulary, to

ensure that your medications are covered.



2. How much will the Part D cover?



All of the Part D plans use a tiering

system to determine how much of each

medication that they will pay for.

Generally, the older less costly

medications are covered more than the

newer more expensive medications. Check

out what your out-of-pocket expense is

going to be, for each of your

medications, before you sign up for Plan.



3. What is the cost of a Part D Plan?



Since the companies providing the Part D

Drug plans are private insurance

companies, the costs will vary from

company to company, and can include a

deductible. In general, the Plans

charging a deductive tend to have a

lower monthly premium, so you need to

add up the annual cost of your

medications, including the premiums and

deductible to find the most cost-

effective Plan for you. The Government

website "Medicare.Gov" has a program to

help you compare Prescription Drug Plans.



4. What about people who cannot afford to

pay for a Part D plan?



There is assistance available for low-

income persons with little savings or

assets. They may qualify for reduced or

eliminated premiums based on their

income. You will need to apply for this

assistance, and the form is available

through your local Social Security

Administration office.



5. When do I have to sign up for a Plan?



You have until May 15, 2006 to sign up

for plan. After that date, if you

choose to sign up, you will be charged

an additional penalty of 1% for every

month that you delay. This is a

lifetime penalty that you will pay, on

top of your usual monthly premium.



The exception to this: If you do have a

Prescription Drug Plan that is equal to

or better than Medicare Part D, and they

have sent you a letter to this effect,

KEEP THE LETTER! If at some point, in

the future, your current coverage lapses

or changes, this letter will save you

from paying the penalty as long as there

is no gap in your transition for your

private insurance carrier to Medicare D.



Confusing? It can be, but your local Social Security Office, the Medicare.Gov website, an Elder Law Attorney or other professional versed in Medicare D can help you make the right choice in a Medicare D Prescription Drug Plan.

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