A Great Social, Civic and Church Club Project! Help One Another With Part D

November 4th 2005

Medicare & You 2006 (MY-06) should have already been in your mailbox.

I must admit and offer high praise to the government and the books sponsor the Center for Medicare and Medicaid Services (CMS). This annual Medicare “bible” has been delivered to its beneficiaries sooner than I can ever remember.

Previous editions of this book sometimes did not arrive until a couple of months after the New Year, which left many confused beneficiaries. This year, it has arrived three months early, as promised by CMS.

In addition to information on the new prescription drug law, MY-06 also includes your Part A and B premiums, deductibles and co-insurances, for the year 2006. In previous editions, this information was often excluded, even though the book would arrive late.

Many find this book a difficult read. However, this year’s edition of some 100 pages is indeed readable and understandable. To many, the language of the CMS, Social Security Administration (SSA) and the insurance industry is indeed a difficult language to comprehend. However, this book should not be “skimmed through;” it should be read in its entirety and pages or issues that you find difficult should be marked and reread. Invest in a yellow marker and yellow line the passages that give you difficulty. Still, primarily due to the language factor of the Medical Industrial Complex, many will not understand it.

A great idea for clubs - social, church and civic – as you prepare for your holiday parties, in lieu of regular meetings, appoint a number of members with the responsibility of deciphering MY-06 and add one additional club meeting, and have all members with books in hand to help one another. I am sure that helping fellow organization members is a primary tenant of your club charter.

Appoint one member of this special group to field questions to the Medicare Help line at (800) 633-4227 and another member to the SSA Help line (800) 772-1213.

Be prepared to wait ten to thirty minutes, and, if their answers don’t quite seem to make sense, call a different operator. Compare notes, then hold your general meeting, and again make sure that all members are told to read the book, mark off what they do not understand and bring their books and notes to the general meeting.

Before you endeavor on project MY-06 there are four items that you should be aware of.

1) The first is rather simple to understand: The income and asset figures indicated in the book to qualify for a full or partial government subsidy are 2005 figures, although the initial open enrollment of Part D will span the timeframe of this Nov. 15th to May 15th 2006. There remains a possibility that the income and asset amounts for subsidies may increase, that could be after the start of 2006, however I sincerely doubt it.

2) The second is that MY-06 fails to give you the effective dates of the initial open enrollment. An example: If one enrolls with an insurer in February, it is their decision whether or not your coverage will be effective retroactively, and my information indicates that it Will Not!

3) The third item: My-06 fails to remind beneficiaries who have duel residencies that not all “standalone” Medicare approved polices will cover you in all states. There are 10 national plans. If you want them, e-mail me. I prefer not to print them; it could be conceived as an endorsement.

4) The fourth and most important item is that there is a major mistake within MY-06.

In section 13 of MY-06 is a list all approved state insurers. Insurers may sell you the “basic” Medicare plan, or plans with additional coverage. The last question states, “If I qualify for extra help will My Full Premium be covered?” The answer shown is “Yes” to every one of the 43 million booklets. However, only if they are basic benefits will Medicare pay for those who qualify for low-income subsidies (Note: There are thirty something "regional Districts), and a number of districts have different "alowable amounts."

So, many of these answers should be “No.”

Be careful and good luck.

By Dan Rohan
Dan’s columns are currently published in a number of states, with a heavy concentration in central Florida. Dan is published somewhere 5 days per week; his column is published as “Senior Advocate” and syndicated as “Senior Focus.”  Contact Dan
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