Signing up for the Medicare Part D prescription benefit
Medicare Part D is a federal program that subsidizes the cost of prescription drugs for Medicare beneficiaries.
Here are five basic things you need to know about the Medicare Part D plan:
Between October 15 and December 7, 2011 you can change your Medicare Part D Plan if you are currently enrolled in one, or you can sign up for the first time. This is known as the open enrollment period. If you don't sign up for a plan during this time, you will be penalized with higher premiums.
Look for any restrictions on the drugs you take. Plans place drugs in tiers - the higher the tier, the higher the co-pay - or you may be required to take an equivalent drug.
Don’t forget about the coverage gap known as the “donut hole” whereby you pay nearly all of your prescription costs up to a limit. You do, however, receive a 50 percent discount on covered brand name drugs. Affordable Care Act measures taking effect from 2011 to 2019 will gradually reduce your share of out-of-pocket expenses, effectively closing the “donut hole” by 2020.
Do your homework and compare plans every year, even if you like your current plan. Many plans increase their premiums or may even drop from their formulary a drug that you're currently taking.
If you have a low income, you may qualify for "extra help" to assist you with premiums, deductibles, co-pays and the coverage gap. Check with a Medicare representative to see if you qualify. Go to medicare.gov or call 1.800.MEDICARE (1.800.633.4227).
How do you choose the best Medicare prescription plan for you? The easiest way is to use the Internet. But before you do, make a complete list of all your prescription medications (make sure you correctly spell the name of each drug). For each drug, include the dosage level and number of daily pills. You might also want to identify the pharmacy where you regularly get these prescriptions filled and write down how much you pay for each.
Next, go to mymedicarematters.org. This website, run by the National Council on Aging, walks you through seven simplified steps to making an informed decision on what plan is in your best interest. Once you've gone through these steps, you're ready to go to medicare.gov and use the Plan Finder. From the home page, click on Health & Drug Plans and then on Compare Health & Drug Plans.
Once you enter your data into the Medicare Plan Finder, it will show all of the plans that cover the prescriptions you take and how much each costs - including annual deductibles, co-pays and monthly premiums. It also calculates your annual costs including the prescriptions you entered. You can compare several plans at a time, but know that there are a lot of choices.
If you do not have access to the Internet, you can call your Area Agency on Aging or local senior center and ask who is hosting Part D seminars and individual counselling sessions to help consumers weigh their options. You can also call 1.800.MEDICARE (1.800.633.4227) 24 hours a day, seven days a week. (TTY users call 1.877.486.2048).