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Medicare Part D

Medicare Part D Prescription Drug Program Starting January 1, 2006, Medicare begins a new drug benefit plan called Medicare Part D that will help seniors pay for their prescription drugs. I did not vote for this bill because I felt it was very confusing and did not adequately meet the needs of seniors in Connecticut and across the country. However, the new drug benefit has been passed into law and this means that seniors, families, physicians, and other healthcare providers will have to make difficult choices. Seniors could potentially save money with this program by choosing the plan that best fits their needs.

Enrolling in Medicare Part D will be a difficult decision. Seniors will have to weigh many different options, such as whether or not they have coverage now, how much they spend on prescriptions each year, how much they think they might spend in the future, among other factors. I encourage seniors and anyone that is working with seniors, has relatives or loved ones that will be transitioning to Medicare Part D, to l review the materials on my website. I hope this information will help in the decision-making process.

More information including key points, a description of the program, how to pick a plan, and information for ConnPACE members.
Medicare Part D Prescription Drug Program Frequently Asked Questions (FAQ).

Key Points for Seniors Considering Enrolling in Medicare Part D:

• You can join a plan starting November 15, 2005. It is important that you join a plan by May 15, 2006 or there will penalty a for late enrollment. To have coverage starting January 1, 2006 you must enroll by December 31, 2005.


• If you have another health insurance prescription drug plan such as from a former employer that is as at least as comprehensive as the new Part D program, then you can delay signing up for Part D without penalty. Call your healthcare provider to find out if this is the case. Also, ask if your employer plans to make any changes to your drug coverage now that Part D coverage is available.


• If you are a Medicaid recipient, you must choose a Medicare Part D plan that best meets your needs. If you do not choose a plan by December 31, 2005 you will automatically be assigned to a prescription drug plan randomly. If you do not like the plan to which you have been randomly assigned, yuou will be able to change.


• Picking drug plans is complicated. Get your doctor involved! He or she knows what medicines you need to keep receiving and which one's can be replaced.

Medicare Part D Description:

The Medicare Part D drug benefit plan acts as a type of insurance for seniors who may not be able to anticipate or pay for the high cost of their medicine. Medicare is working with private insurance and other companies to bring these seniors a variety of plans.

As with some insurance policies, you will have payment obligations. Under Medicare part D many seniors will have to pay an insurance premium each month, an annual deductible, and part of the costs of your drug. How much you pay out-of-pocket will depend on the plan you choose.

Anyone who is over 65 can join the drug benefits program. Your age, income, or health conditions do not affect your eligibility.

Picking a Prescription Drug Plan (PDP):

There will be 17 plans in Connecticut from which you can choose. It can be confusing to understand the differences among all of the plans and to figure out what is the best choice for you. Here are some things to keep in mind when you are making your decision:

1. Look at the drug coverage you have right now. What does it cover? Compare the coverage you are getting now to each of the drug benefit plans.
2. Make a list of all the drugs you take. Write down their names, dosages, and how much they cost you each month. Having this list ready will make it easier when you are looking at which drugs different plans cover. Now compare your drug lists to what is covered by a prescription drug plan. Are they there? If they are not, you are unlikely to get them if you select this plan.
3. Compare how much you pay for drugs now and how much you will save by participating in the new prescription drug program. You should be saving money, think you will be saving money down the road, or want to insure yourself against medical catastrophe to justify participation in this plan.
4. If you need some help, click on the following web site from the Connecticut Department of Social Services : http://www.medicareadvocacy.org/CHOICES/ChoicesPartD.htm

After deciding if a plan is a good idea for you and which plan you want, it is important that you enroll by December 31, 2005 to have coverage start immediately on January 1, 2006. If you wait until after May 15, 2006, you will have to pay a penalty fee equal to 1% of the base premium for each month that you do not have "creditable coverage". The late enrollment penalty lasts for the remainder of the time that the beneficiary is enrolled in a Part D plan. "Creditable coverage" means that you have another health insurance plan that is at least as comprehensive in its coverage as Medicare. You can call your health plan provider to find out if you have creditable coverage.

Be sure to examine mailings that have been sent to your home in the summer and fall of 2005. They include important information on the drug benefit plan, what plans available in your community might look like, and what kind of benefits you can expect from these plans.

Information for those enrolled in ConnPACE:

1. You should receive mailings about Medicare Part D from both ConnPACE and Medicare. Some of you will also receive information from Social Security.
2. You must enroll in a Medicare Part D prescription plan by December 31, 2005 to ensure continued coverage by ConnPACE on January 1, 2006.
3. ConnPACE will pay your Medicare Part D premium as long as you are enrolled in ConnPACE.
4. The new Medicare Part D drug plan may mean that you have access to fewer drugs and you may face higher out-of-pocket costs. Therefore, it is particularly important to determine which plans will cost you the least, based on your prescription needs.

For more information:

Medicare: can help you get more information on the Medicare Part D drug benefit, how to choose a plan, and where you can get home help.
Call: 1-800-MEDICARE (1-800-633-4227) TTY users: 1-877-486-2048

Connecticut State Medicaid Office: can help dual-eligible seniors understand how to make the transition to the Medicare Part D drug benefit.
Call: 1-800-842-1508

Social Security: can help you determine whether or not you are low-income and qualify for additional financial assistance.
Call: 1-800-772-1213 (TTY users: 1-800-325-0778).

Connecticut Department of Social Services, Elderly Division, CHOICES: can help you get a wide range of services and referrals for seniors.
Call: 1-800-994-9422 (TTY users: 860-842-5424)

Connecticut Insurance Department: can give you information about insurance plans and costs and they have special resources for seniors.
Call: 1-800-203-3447

Connecticut Pharmaceutical Assistance Contract to the Elderly and the Disabled (ConnPACE): can help you understand what your choices might be if you are covered by ConnPACE.
Call: 1-800-423-5026 (in-state) or 860-832-9265 (out-of-state)

Office of Protection and Advocacy for Persons with Disabilities: can provide extra support to protect the legal rights of people with disabilities.
Call: 1-800-842-7303

Local area aging agencies:
Call: 1-800-677-1116

American Association of Retired Persons
Call: 1-888-OUR-AARP (1-888-687-2277)

Medicare Rights Center: provides information on Medicare benefits and specifically the Medicare Part D drug benefit.

MedRx Connect: provides information on the Medicare Part D drug benefit.

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