MEDICARE PRESCRIPTION DRUG INFORMATION FOR SENIORS
Beginning January 1, 2006, Medicare began offering prescription drug coverage to people with Medicare. For the first time, you can choose coverage for this important health need, and Medicare will help pay for it. Medicare will provide coverage to help you pay for both brand-name and generic drugs you need. To get Medicare prescription drug coverage, you must choose and join a Medicare drug plan.
Medicare drug plans will be offered by insurance companies and other private companies approved by Medicare. There are two types of Medicare plans.
- There will be Medicare Prescription Drug Plans that add coverage to the Original Medicare Plan, Medicare Private Fee-for Service Plans that don't offer Medicare prescription drug coverage, and Medicare Cost Plans.
- There will also be prescription drug coverage that is a part of Medicare Advantage Plans (like a HMO, PPO, or a PFFS Plan) and other Medicare Health Plans. You would get all of your health care, including prescription drug coverage, through these plans. If you have limited income and resources, you may be able to get help with drug plan costs.
What is Medicare prescription drug coverage? Medicare prescription drug coverage is insurance that covers 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 can get Medicare prescription drug coverage? Everyone with Medicare is eligible for this coverage, regardless of income and resources, health status, or current prescription expenses.
When can I get Medicare prescription drug coverage? You may sign up from November 15, 2005 to May 15, 2006. If you join by December 31, 2005, your coverage will start January 1, 2006, and you won't miss a day of coverage. If you don't sign up when you are first eligible or by May 15, 2006, you may pay a penalty. Your next opportunity to enroll is from November 15, 2006 to December 31, 2006.
How does Medicare prescription drug coverage work? Your decision about Medicare prescription drug coverage depends on the kind of health care coverage you have now. There are two ways to get Medicare prescription drug coverage. You can join a Medicare prescription drug plan or you can join a Medicare Advantage Plan or other Medicare Health Plans that offer drug coverage.
Whatever plan you choose, Medicare drug coverage will help you by covering brand-name and generic drugs at pharmacies that are convenient for you.
Like other insurance, if you join, you will pay a monthly premium, which varies by plan, and a yearly deductible (no more than $250 in 2006). You will also pay a part of the cost of your prescriptions, including a co-payment or co-insurance. Costs will vary depending on which drug plan you choose. Some plans may offer more coverage and additional drugs for a higher monthly premium. If you have limited income and resources, and you qualify for extra help, you may not have to pay a premium or deductible.
Why should I get Medicare prescription drug coverage? Medicare prescription drug coverage provides greater peace of mind by protecting you from unexpected drug expenses. Even if you don't use a lot of prescription drugs now, you should still consider joining. As we age, most people need prescription drugs to stay healthy. For most people, joining now means protecting yourself from unexpected prescription drug bills in the future.
What if I have a limited income and resources? There is extra help for people with limited income and resources. Almost 1 in 3 people with Medicare will qualify for extra help and Medicare will pay for almost all of their prescription drug costs.
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ASSISTANCE: HELPFUL LINKS / PHONE NUMBERS
- Horry County Council On Aging - (843) 546-5231
- SC State Health Insurance Assistance Program - (800) 868-9095
- The Official U.S. Government Site for People with Medicare - Learn About the New Medicare Prescription Drug Coverage - or (800) 633-4227
- Medicare Modernization Act - Prescription Drug Benefit / Medicare Advantage Programs
- Centers for Medicare & Medicaid Services - Prescription drug coverage to all people with Medicare, expanded health plan options, improved health care access for rural Americans, and preventive care services, such as flu shots and mammograms.
- Centers for Medicare & Medicaid Services (CMS) - Prescription Drug Help For Those With Limited Income and Resources
- Social Security Administration - Provides persons with limited income and resources extra help paying for their prescription drugs - or (800) 772-1213