Confused About Medicare Part D?
Congressman
Tom Petri
Tom Petri
November 28, 2005
Senior citizens all across the country are confused about the new Medicare Part D prescription drug benefit - and I don't blame them.
Congress wanted to craft a plan that would encourage private insurers to compete against each other to offer the most attractive federally-subsidized plans possible at reasonable rates. The response from insurers has been strong, which is a good thing. But it also means that seniors need to research their options carefully to find the best deal available.
Seniors should have received the Medicare &You Handbook which was mailed in October to help explain the changes in the program, but the booklet is just a place to start. Many adult children of frail seniors will need to step in to make sure their parents sign up for appropriate coverage.
To help people navigate through this important addition to Medicare, I am hosting two Town Meetings on Prescription Drug Benefits on Friday, Dec. 2. Joining me for the meetings will be Peter Leonis, Government Affairs Liaison at the U.S. Department of Health and Human Services Center for Medicare and Medicaid Services. Mr. Leonis will make a presentation on the new program and will participate in a question and answer session.
The first meeting will take place Dec. 2 from 10 to 11 am at the Sheboygan Senior Center at 428 Wisconsin Ave. in Sheboygan. Registration begins at 9:30 am.
The second meeting will take place Dec. 2 from 2 to 3 pm at the Beaver Dam Senior Center, 114 East Third Street in Beaver Dam. Registration begins at 1:30 pm.
In briefest form, every senior and every adult child caring for a senior should know the following:
To get Medicare prescription drug coverage, you must choose and enroll in a Medicare prescription drug plan.
Enrollment began Nov. 15. If you join by December 31, you will be covered on Jan. 1, 2006, which is the first day the program actually starts to help cover prescription costs.
If you join, your costs will vary depending on which plan you choose. In general, you pay a monthly premium (generally around $37 in 2006) and a yearly deductible (up to the first $250 in 2006). You will also pay a share of your prescription drug costs, and your plan pays a share. Medicare helps pay for drugs up to a limit ($2,250 in total) and once your total out-of-pocket costs for drugs reach $3,600, you pay five percent of the costs and Medicare pays 95 percent of the costs for the rest of the year.
Many people with limited income and least resources will get extra help paying for their prescription drug coverage. People with the lowest incomes and resources will get the most help. If you are in this group, you may already have received information in the mail from the Social Security Administration or from Medicare telling you what to do.
If you already have prescription drug coverage through your Medicare private health plan or other insurance, check with your current plan to see if this coverage is changing.
If you are currently eligible and decide to join a Medicare prescription drug plan, it's important for you to do so by May 15 after which a penalty will be applied.
Further information is available at www.medicare.gov on the Web or by calling 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048. For more information on who can get extra help with prescription drug costs and how to apply, call the Social Security Administration at 1-800-772-1213 or visit www.socialsecurity.gov on the Web.
Congress wanted to craft a plan that would encourage private insurers to compete against each other to offer the most attractive federally-subsidized plans possible at reasonable rates. The response from insurers has been strong, which is a good thing. But it also means that seniors need to research their options carefully to find the best deal available.
Seniors should have received the Medicare &You Handbook which was mailed in October to help explain the changes in the program, but the booklet is just a place to start. Many adult children of frail seniors will need to step in to make sure their parents sign up for appropriate coverage.
To help people navigate through this important addition to Medicare, I am hosting two Town Meetings on Prescription Drug Benefits on Friday, Dec. 2. Joining me for the meetings will be Peter Leonis, Government Affairs Liaison at the U.S. Department of Health and Human Services Center for Medicare and Medicaid Services. Mr. Leonis will make a presentation on the new program and will participate in a question and answer session.
The first meeting will take place Dec. 2 from 10 to 11 am at the Sheboygan Senior Center at 428 Wisconsin Ave. in Sheboygan. Registration begins at 9:30 am.
The second meeting will take place Dec. 2 from 2 to 3 pm at the Beaver Dam Senior Center, 114 East Third Street in Beaver Dam. Registration begins at 1:30 pm.
In briefest form, every senior and every adult child caring for a senior should know the following:
To get Medicare prescription drug coverage, you must choose and enroll in a Medicare prescription drug plan.
Enrollment began Nov. 15. If you join by December 31, you will be covered on Jan. 1, 2006, which is the first day the program actually starts to help cover prescription costs.
If you join, your costs will vary depending on which plan you choose. In general, you pay a monthly premium (generally around $37 in 2006) and a yearly deductible (up to the first $250 in 2006). You will also pay a share of your prescription drug costs, and your plan pays a share. Medicare helps pay for drugs up to a limit ($2,250 in total) and once your total out-of-pocket costs for drugs reach $3,600, you pay five percent of the costs and Medicare pays 95 percent of the costs for the rest of the year.
Many people with limited income and least resources will get extra help paying for their prescription drug coverage. People with the lowest incomes and resources will get the most help. If you are in this group, you may already have received information in the mail from the Social Security Administration or from Medicare telling you what to do.
If you already have prescription drug coverage through your Medicare private health plan or other insurance, check with your current plan to see if this coverage is changing.
If you are currently eligible and decide to join a Medicare prescription drug plan, it's important for you to do so by May 15 after which a penalty will be applied.
Further information is available at www.medicare.gov on the Web or by calling 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048. For more information on who can get extra help with prescription drug costs and how to apply, call the Social Security Administration at 1-800-772-1213 or visit www.socialsecurity.gov on the Web.
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