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You may have started receiving letters and notices regarding
Medicare’s prescription drug coverage, which will help you pay
for brand name and generic drugs. The voluntary program takes
effect January 1, 2006. It’s important to open, read and save
all coverage notices to ensure you understand the benefits you
are entitled to.
Unfortunately, the program created by the federal government is
tremendously bureaucratic and confusing. To help you find your
way through the maze of regulations, here is some basic
information:
The new Medicare prescription drug program is voluntary. However,
if you have both Medicaid and Medicare you must enroll in a Medicare
prescription drug plan. If you do not pick a plan and enroll before
December 31, 2005, you will be enrolled in one of the new drug plans
automatically because your Medicaid drug benefit will end on that
date. If you have drug coverage (other than Medicaid) now, your current
insurance company has to provide you with a notice indicating if
your current prescription coverage is "as good as or better than"
the standard Medicare plan. If it is, you do not have to consider joining a
Medicare plan at this time. Otherwise, you should consider signing up
for a Medicare drug plan between November 15, 2005 and May 15, 2006
to avoid paying a late enrollment penalty. Seniors with EPIC can keep their EPIC coverage. For some,
particularly those eligible for "extra hel" for low income
beneficiaries, enrolling in the Medicare drug program will mean more
savings. EPIC will waive fees for low-income enrollees eligible for
full "extra help" who join a Medicare plan. The new Medicare drug program provides "extra help"
to pay for drug costs for beneficiaries with lower incomes;
contact your local social security office or area agency on
aging. Those already in Medicaid or in one of the Medicare
savings programs (QMB, SMB and QI-1) will be eligible
automatically for "extra help." This new Medicare drug benefit will only be available
through private plans. This means that in order to get
prescription drugs covered through Medicare, New Yorkers must
enroll in one of the plans offering the benefit in New York
State. HMOs and other Medicare Advantage plans will also be
offering the new prescription drug benefit.
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