03.14.06

Burr Provides Q & A on Medicare Prescription Drug Coverage

May 15 deadline for signing up without penalty approaching Visit the Medicare web site here.

The beginning of 2006 brought major improvements to Medicare. Every American with Medicare, regardless of income, health status, or prescription drug usage was given access to prescription drug coverage. As the May 15 deadline for seniors to sign up for Medicare prescription drug coverage without penalty quickly approaches, I want to provide answers to commonly asked questions.

Starting any new program can be frustrating. It is understandable to have questions about what the new coverage means for Medicare beneficiaries and how to access and choose the best plan to meet specific needs. Seniors do not need to be an expert to make the right choice. There are many services and Medicare personnel available to help.

There are two dates that need to be marked on your calendar. The deadline to enroll in a 2006 Medicare prescription drug plan and pay lower premiums is May 15, 2006. The next opportunity to enroll in a Medicare prescription drug plan if you miss the May 15 deadline is November 15, 2006. The November 15 enrollment period begins the 2007 prescription drug season and you will likely pay a penalty for not enrolling in May.

What is Medicare Prescription Drug Coverage?

• Medicare prescription drug coverage is insurance coverage for both brand-name and generic prescription drugs at participating pharmacies in your area. Medicare prescription drug coverage provides protection for people who have very high drug costs.

Who qualifies for the Medicare Prescription Drug Plan?

• Anyone on Medicare has access to a prescription drug plan. Regardless of income, health status, or prescription drug usage, you are eligible for a prescription drug plan if you are a Medicare beneficiary.

• Extra help with prescription drug costs is available for people with limited income and resources. Almost one in three seniors with Medicare will qualify for additional assistance. If you qualify for this extra assistance, Medicare will pay for almost all of your prescription drug costs. You can apply or get more information by calling Social Security at 1-800-772-1213 or visiting www.socialsecurity.gov.

How do I get information about the different prescription drug plans available through Medicare?

• The Medicare call center is available 24 hours a day by calling 1-800-633-4227. Medicare employees are available to give you personal help in choosing a plan. Before you call, please have your Medicare Card, a list of the drugs you use, and the name of your pharmacy in hand.

• The Medicare website can be accessed at www.medicare.gov . This comprehensive site allows you to enroll in the prescription drug plan online and access materials you need to choose the best plan for you. Senator Burr has a link to the Medicare program on his website at https://www.burr.senate.gov .

• The North Carolina Department of Insurance and Seniors Health Insurance Information Program (SHIIP) provide counselors to answer questions about Medicare prescription drug coverage. You may contact SHIIP by calling 1-800-443-9354 or by visiting the North Carolina SHIIP website at www.ncshiip.com. Local counselors are available in most North Carolina counties.

How do I choose the best prescription drug plan to meet my needs?

• Each Medicare drug plan has a list of the prescription drugs it will cover. When comparing plans it is important to find the plans that cover all or most of the drugs you take.

• Medicare prescription drug plans must contract with pharmacies in your community, but it is important to note that not all pharmacies contract with all prescription drug plans. When choosing a plan, make sure your local pharmacy or a pharmacy near you works with the plan you choose.

• Make sure the monthly premium for the plan you choose is affordable for you.

How much will a prescription drug plan cost me?

• All seniors, except lower income individuals, who have a Medicare prescription drug plan, pay a monthly premium now. Premiums vary by plan; however, on average most monthly premiums in North Carolina range from under $20 - $68.

• Unless you are lower income, you will pay a deductible. A deductible is the amount you pay for your prescriptions before your plan begins to share the costs. No Medicare prescription drug plan may have a deductible more than $250.

• Under the Medicare prescription drug plan you will pay co-payments. A co-payment is the amount you pay for your prescriptions after you have paid the deductible. In some plans, you pay a co-payment which is a set amount or pay coinsurance which is a percentage of the cost for any prescription. Different plans have different co-payments. You may pay less for generic drugs than brand names or some brand name drugs might have a lower co-payment than other brand name drugs. In some plans your share of the cost can increase when your prescription drug costs reach a certain limit.


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