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Medicare Part D

Four Steps to Get Medicare Prescription Drug Coverage
To help people with Medicare take advantage of the new Medicare prescription drug coverage, there are four steps you can think about while making a decision:

1. Getting Started
The decision to get Medicare prescription drug coverage depends on how you pay for your drugs now and how you get your Medicare coverage. Most people with Medicare pay for drugs and get their Medicare in one of five ways:

  • Original Medicare only, or Original Medicare and a Medigap (‘Supplement') Policy without drug coverage. The new Medicare drug coverage will cover half of the costs for you if you have this kind of coverage now. Enhanced options are available that provide more coverage.
  • Original Medicare and a Medigap (‘Supplement') Policy with drug coverage. The new Medicare drug coverage will generally provide much more comprehensive coverage at a lower cost.
  • Retiree or union coverage. In most cases, people with good retiree or union coverage can continue to get it, with new financial support from Medicare.
  • Medicare Advantage Plan (like an HMO or PPO) or other Medicare Health Plan, which already include drug coverage and other extra benefits.
  • Dual coverage from Medicare with Medicaid drug coverage. These people will automatically get comprehensive prescription drug coverage from Medicare, starting on January 1.

    2. Determining what matters most and reviewing plan options
    Once you decide that you want prescription drug coverage, think about what matters most to you. There are a range of plan options available, so you can focus on the kind of coverage you prefer. There are two ways you can get your Medicare drug coverage.You can add drug coverage to the traditional Medicare plan through a “stand alone” prescription drug plan. Or you can get drug coverage and the rest of your Medicare coverage through a Medicare Advantage plan, like an HMO or PPO, that typically provides more benefits at a significantly lower cost through a network of doctors and hospitals. No matter what type of plan you choose, you can choose a plan that reflects what you want in terms of cost, coverage and convenience.
    · Cost: What you pay for the coverage, including premiums, deductible, and payments for your drugs.
    · Coverage: What benefits are provided (like coverage in the “coverage gap” and other coverage enhancements), which drugs are covered and the rules (like prior authorization) for getting those drugs.
    · Convenience: Which pharmacies are part of the plan and whether the plan has a mail-order option.
    The Centers for Medicare & Medicaid Services has created an online resource, Landscape of Local Plans . This resource helps you find Medicare prescription drug plans by state or Medicare Advantage plans with prescription drug coverage by county. It lets you see the plans in your area that offer drug coverage, including basic information to help you find ones that meet your needs based on cost, coverage, and convenience.

    3. Choosing a plan
    Beginning on November 15, people with Medicare can choose a prescription drug plan. There are many ways to choose a plan. You may rely on advice from people you know or trust, or choose a plan you are already familiar with, or use the Landscape of Local Plans located on medicare.gov to find a plan that meets your needs. All of the plan options must meet or exceed Medicare's standards for coverage, including coverage for medically necessary drugs.
    If you want to make more specific plan comparisons based on what matters to you, you can get personalized information from the Medicare Prescription Drug Plan Finder . The Medicare Prescription Drug Plan Finder can be accessed at     www.medicare.gov , or through a customer service representative at 1-800-MEDICARE, or through the many organizations working with Medicare to help people take advantage of the new drug coverage.

    4. Enroll
    You can enroll in a plan starting November 15. Medicare will have an online Enrollment Center available on that date at     www.medicare.gov. You can also enroll by calling the plan's toll free number, by mailing in an application to the plan, or by visiting the plan's website. Coverage begins January 1, 2006 if you join a plan by December 31, 2005. The deadline to enroll to get coverage next year is May 15, 2006.
     Medicare Contact Information

Medicare has a helpline that is there for you – 24/7 – at 1-800-MEDICARE, TTY 1-877-486-2048. Medicare customer service representatives will provide information and answers to your questions. Also, visit www.medicare.gov , or contact 1-800-MEDICARE or www.eldercare.gov to find out about local counseling and assistance available in your area.

For help with questions about eligibility for and enrolling in Medicare, Social Security retirement benefits, or disability benefits you can call the Social Security Administration at 1-800-772-1213, TTY 1-800-325-0778.