Senior and Disabilities Services

Prescription Drug Coverage/Medicare Part D

 

Medicare Prescription Drug Plan OPEN ENROLLMENT is November 15 through Dec 31st
Everyone with a Medicare prescription drug plan needs to read their mail carefully and make important decisions about staying in the current plan for 2009 or comparing with new plans with lower fees for 2010.  We have a seminar at Providence Alaska Medical Center on November 5th from 1- 4 p.m. to help you learn how to do a drug plan comparison.  We can do it for you, as well.  Call us! 800-478-6065 or 269-3680 if you’re in Anchorage.

 

Do you need a Part D Plan?

Medicare Part D:
Prescription Drug Plan Benefit
The Medicare Prescription Drug Plans are provided by private companies that sell plans approved by Medicare. These plans are called Medicare Prescription Drug Plans or PDPs. You can identify an approved plan by the MedicareRx logo. All people new to Medicare have a seven month window to enroll in a Medicare Part D drug plan – three months before, the month of, and three months after their Medicare becomes effective. Remember, the month you enroll will affect the month your PDP is effective.

All people with Medicare are eligible to enroll in a PDP, regardless of income or assets; however, unless they are new to Medicare or are entitled to a Special Enrollment Period, they must enroll during the Annual Election Period which is November 15 through December 31. Options and features will vary from
plan to plan such as drug lists with generic and brand name medications,  drug prior approval requirements, and deductible and co-payment structures.  You can only select one Medicare PDP. All of these differences will have a direct impact on the plan premium. Beneficiaries will want to compare plans and select the one plan that best meets their individual needs, such as, all your prescriptions are on the plan’s list of coverage drugs, you can use your preferred pharmacy, and the premium is affordable. For assistance in understanding and enrolling in a Medicare PDP, please refer to your current Medicare & You Handbook, which is published by the Centers for Medicare and Medicaid Services (CMS). Or you can visit the Medicare Web site at www.Medicare.gov or contact Alaska’s Medicare Information Office at 1-800-478-6065 or from Anchorage 269-3680.

In Alaska there are dozens of approved companies offering PDPs. Some of the companies offer plans that have national coverage, which is especially important for beneficiaries who have residences in more than one state.

There is assistance available for people with Medicare who have limited incomes and resources. If they quality, they can receive assistance with premiums, deductibles and co-payments for their prescriptions. If someone has an annual income of below $20,292  as an individual or $27,312 as a married couple living together and assets lower than $12,510 as an individual or $25,010 as a married couple living together (includes $1,500/person funeral or burial expense), they can visit their local Social Security office, call Social Security toll free at 1-800-772-1213, visit www.socialsecurity.gov, or request an extra help
assistance application by contacting the Medicare Information Office.

NOTE: If you applied for extra help and received a letter stating that you do not qualify for assistance, you are still eligible to enroll in a PDP but will have the responsibility to pay the premiums, deductibles and co-payments. 

 

2009 Basic Medicare Prescription Drug Plan Model

Actual Drug Costs

Medicare Pays

Beneficiary Pays

Cumulative Beneficiary Out-of-Pocket Total

$0 - $295

$0

$295 (deductible)

$295

$295.01 - $2,700

$1,803.75 (75%)

$601.25 (25%)

$896.25 ($295+601.25)

$2,700.01 - $6,153.75

$0

$3,453.75 (100%)

$4,350 ($896.25+$3,453.75)

$6,153.76+

About 95%

About 5%

varies

 

 

 

 

Go to an overview of the Medicare Prescription drug benefits >