Medicare Part D Prescription Drug Program
Part D is a voluntary prescription drug insurance program through Medicare called "Medicare Prescription Drug Coverage" that started January 1, 2006. Medicare created a standard benefit design and asked private insurance companies to market plans that are equal to or better than the standard Medicare design. Click here for a look at the standard benefit design created by Medicare (adjusted for 2009).
This drug coverage is available to everyone who has Medicare, regardless of income or health status. If you have a limited income, you may get extra help to cover prescription drugs for little or no cost. For 2009, in California, there are 22 companies offering 51 different Part D plans. You choose the drug plan and pay a monthly premium. In addition to a premium, you will also have a share of costs determined by the plan you select. Companies have some flexibility with the drugs they choose to cover under their plan (drug formulary) and the pharmacies they contract with, but there are some minimum standards. With few exceptions the plans can not change during a coverage year (Jan 1 - Dec. 31).
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Important Medicare Phone #s
- For Medicare enrollment: contact Social Security at 1-800-772-1213
- For Medicare coverage questions: call 1-800-MEDICARE
- For government sponsored assistance with Medicare and Social Security contact HICAP (Health Insurance Counseling and Advocacy Program) at (800) 434-0222.
- For information about Medicare Supplemental coverage, contact Phil or John at OnlyHealthInsurance at 1-800-924-1411.
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Carriers can change premiums, prescription drug formularies and plan designs for each new plan year, but beneficiaries can also change plans without restrictions on health or pre-existing conditions. This annual open enrollment period (Nov 15 - Dec 31) allows people to change plans to fit new prescription drug needs that offer a better value. In California, plans for 2009 range in cost from $18 - $129. The best place to review plans is on Medicare's web site: www.medicare.gov.
Though this is a voluntary program, you may be penalized if you do not enroll when you are first eligible and do not have other coverage that is as good as or better than Medicare's standard plan design. The penalty is 1% for every month you were eligible but did not enroll.
Note: it is very important to discuss your particular circumstances with an insurance professional. By enrolling in a Prescription Drug Plan, you may "void" your current coverage. If you are unsure about your eligibility contact Medicare or Social Security. Though we do not market and sell Part D plans, we provide a free analysis and recommendation to clients who are purchasing a Medicare Supplement. Give us a call today to understand your options and for information about the solutions we recommend.
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