October 1st 2005

This weekend solicitations will begin for the new Medicare drug prescription plans to be implemented next year.  The new program, known as Medicare Part D, will begin on January 1, 2006.  There will be over 40 options available to beneficiaries in almost every state.  According to the Bush administration most plans will differ slightly from the standard minimum benefit mandated by Congress.

Medicare recipients must pay a $250 deductible and will then be responsible for 25 percent of annual drug costs ranging from $251 to $2,250, according to the New York Times.  Recipients will be responsible for the next $2,850 in expenses and after that Medicare will pay about 95% of the expenses over $5,100. 

This leaves a “coverage gap” of between $2,251 and $5,099.  Some plans may offer less than a $250 deductible.  In most states insurers may also provide drug coverage for those caught in the coverage gap. 

Enrollment for the new plans begins November 15^th.  More choices can sometimes be confusing.  Each state may offer different plans, and in some areas the drug coverage is also offered as part of the Medicare-approved HMO membership plan. Some critics complain that the programs may be so confusing that many seniors may not sign up for any of them. 

Not all drugs will be covered.  Advocates for the plan insist that coverage is worthwhile for most people.  The program is voluntary, so seniors may want to compare the coverage to what they already have. 

According to AARP, if you have limited income and resources Medicare will pay most of your drug costs.  If your income is less than $14,355 a year for a single person or $19,245 for a married couple you may be considered a limited income beneficiary.   You may qualify for a plan with limited or low co-payments and no deductible. 

There are a couple things to consider when choosing a plan.  You will want to know where you can fill your prescriptions.  Some insurers may require you to fill them only at certain pharmacies.  Also, will the drugs you take be covered by the plan and how much will it cost you out-of-pocket.  Compare that to what you have right now. 

If you planning on moving to a new state you may want to investigate whether the plan will cover you there. According to AARP, after May 15, 2006, most people who are already in Medicare will not have another opportunity to enroll until the following November and will be penalized for signing up late. There will be exceptions—for example, if you move out of your plan’s service area, or if you lose creditable drug coverage from another source through no fault of your own.  

By Dan Wilson
Best Syndication Staff Writer

Medicare Books

Keywords and misspellings:  Medicare Medecare Medicair Medicaire plan d