Schuylkill Plus Magazine

Medicare’s new prescription drug coverage starts January 1, 2006. It will offer most people who are eligible for Medicare an opportunity to save on the cost of their medications.
Part D prescription drug coverage will work in a different way from Medicare Part A and Part B. In order to receive the coverage you will have to choose a plan from a pharmacy benefits manager.
If you already have drug coverage, you will want to compare your present plan with the plans being offered under Medicare Part D. If you do not have prescription drug coverage, it is important to look at and compare Part D plans.
Bracey Pharmacy has prepared this guide to help explain how Medicare Part D will work. We have endeavored to help explain the things you will have to decide in the near future. It is not designed to aid in selecting a specific plan.
We encourage you to speak with your pharmacist before you make any decision.

10 Things to Know About Part D Plans

1. Part D plans are available to anyone who is eligible for Medicare in the U.S.A.
a. You cannot be denied for health reasons.
b. The program is voluntary.
c. The enrollment period starts November 15.

2. Participation is not free.
a. In most cases there is a monthly cost.

3. Part D Plans are pharmacy benefit plans.
a. They are private insurance plans.
b. Most people will pay a monthly premium.

4. Prescription plans negotiate lower prices with drug manufacturers and will
Pass those savings on to you.

5. Freedom of Choice
a. You will have a choice in plans. Details of individual plans will be available after October 1.

6. Types of Plans
a. Prescription Drug Plans which cover medications and are used with traditional Medicare or supplemental plans.
b. Medicare Advantage plus Prescription Drug that includes medical coverage.

7. Enrollment
a. Enrollment begins November 15, 2005 and ends on May 15, 2006.
b. A late enrollment fee of about 1 percent of your premium will be applied for each month you delay in enrolling.

8. All plans will have an approved government list of drugs that will be covered.
a. The list may vary from plan to plan.
b. You need to compare lists to see which plan is best for you.
c. Our pharmacists will be happy to assist you with this task.

9. Medication will not be free.
a. Co Pays and dedutibles will be applicable to all plans.

10. Low income Medicare recipients may qualify for additional aid. In some cases premiums and payments will be reduced.

What Do You Do?
Get Ready. You won’t be able to make your final decision until late fall. But it will be good to begin reviewing how Part D works now.
Review Your Current Coverage. Your choice of drug coverage and your decision to participate will depend on the kind of health care coverage you now have and will have in 2006.
Compile Your Information. Collect information you need to make your decision. Save any correspondence from your present insurance company and any other information you receive. Our pharmacy will be happy to help you understand the complexities of Medicare Part D.

Compare Are Prescription Drug Plans. Don’t sign up for the first plan you receive in the mail. Take some time to compare the various plans that will be available in our area and pick the plan that is best for you.

Talk to the Pharmacists at Bracey Pharmacy.

Dates to Remember
November 15, first day you will bee able to enroll in a Medicare Part D drug plan.
January 1, 2006, first day coverage begins under Medicare Part D.
May 15, 2006, last day you may enroll in Medicare Part D plans without a late enrollment penalty.
Example of the Standard Plan
This example explains the standard Medicare part D plan that was enacted by Congress. Individual plans offered by pharmacy benefit managers may vary.
First $250.00 of Prescription Drugs:
This is your deductible. You will pay 100 percent ($250.00) for your medication. The plan will pay 0 percent.
Next $2,00.00 of Prescription Drugs:
You will pay 25 percent ($500 in co-insurance. The plan will pay 75 percent ($1,500).
Next $2,850.00 of Prescription Drugs:
This is thhe “gap” where you will pay 100 percent ($2,850) out of pocket. The plan will pay nothing during this period.
Catastrophic Coverage:
After you have spent $3,600 out of pocket:
($250 deductible/$500 co-insurance/$2,850 gap)
You will then pay about 5 percent (or a dollar co-pay amount) and your plan will pay 95 percent for drugs received to the end of the calendar year.
The total cost you will incur (not including your premium) for your covered prescriptions until Catastrophic Coverage begins is $3,600. The total value of drugs you will receive during this same period will be $5,100.
(The uninsured person who takes very little medication or inexpensive medication may not benefit from Medicare Part D. The uninsured person who has a major illness and uses a lot of medication will definitely benefit. Pace and PaceNET recipients will remain part of the PACE Program and do not, at this time, need to select a Part D provider.