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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 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.
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