The Medicare Prescription Drug Benefit (Part D)
Medicare Part D has established an optional prescription drug benefit for individuals who are entitled to or enrolled in Medicare benefits under Medicare Part A and Part B. Coverage for this prescription drug benefit is being provided through private prescription drug plans (PDPs) that offer drug-only coverage, or through Medicare Advantage (MA) plans that offer integrated prescription drug and health care coverage.
The following brochures and fact sheets, developed by Novartis Pharmaceuticals Corporation, will help you understand the basics of Medicare prescription drug coverage:
- A Guide to Understanding Medicare Prescription Drug Coverage
- Medicare Glossary of Key Terms
- Introducing Prescription Drug Coverage Under Medicare
- Frequently Asked Questions about the New Medicare Prescription Drug Coverage
You also may want to consult the Medicare Part D article on common Q and A's to help clarify the components of the program. The Virginia Insurance Counseling and Assistance Program also is an excellent resource for answers to questions you may have.
Of course, the most important resource is Medicare & You. This is the official government handbook for the Medicare program andincludes extensive information on Prescription Drug Coverage. Every Medicare recipient receives a copy of Medicare & You each fall. In addition, it is available on the web at www.medicare.gov/publications/pubs/pdf/10050.pdf
The Medicare web site also offers comprehensive information on Medicare prescription drug benefits, including dozens of Frequently Asked Questions, charts comparing the benefits and costs of each plan within each state, and details on every aspect of the program. Visit http://www.medicare.gov and click on the prescription drug coverage button in the upper left of the site.
Get Your Facts Straight:
To prepare for any calls you make regarding Medicare Prescription Drug Coverage, have the following items handy:
- A list of the medications you are taking including name and dosage
- As exact a figure as you can get as to how much you spend on your prescriptions per month and year
- Your red, white and blue Medicare Insurance Card (you will be asked for the effective date on the card)
- Any letters you have received regarding current coverage of prescription drugs (if applicable) and any health insurance cards
- The name of the pharmacy you would like to use or a list of convenient pharmacies/mail order services
- A pad and paper to take notes and jot down numbers
Medicare also offers a Personal Information Worksheet that you can fill out and have ready when you are comparing plans or calling others for assistance.
If You Can't Afford Coverage:
People with limited income and resources may get extra help with the cost of the Medicare Drug Plan. The cost sharing will vary according to each individual's income and resources. This article (in English and Spanish) from the Social Security Administration provides details on the Help Available to Pay Costs of Medicare's New Prescription Drug Program. In addition, consult these resources for more information:
- Online Qualifier Tool: The Social Security Administration has provided an Online Qualifier Tool so you can see if you or someone you know qualifies for extra help with prescriptions. This tool is located at https://secure.ssa.gov/apps6z/i1020/main.html.
- Application Requirements: If you decide that you might qualify for extra help and would like to apply, this sheet will assist you in knowing what you need to fill out the application. The Social Security Administration has made applications for extra help with Medicare prescription drug costs available online.
- BenefitsCheckUpRx: BenefitsCheckUpRx screens beneficiaries for eligibility and lets them apply online for the extra help through the Social Security Administration's Web site. BenefitsCheckUpRx also helps seniors enroll in other health care and prescription drug assistance programs and apply for other needs-based government programs, including the Medicare Savings Programs and federal, state, and private programs that can save seniors money.
- Food Stamps and Part D Fact Sheet: For people with Food Stamps who will qualify for Medicare Part D, this fact sheet explains the interaction between Food Stamps and Part D.
To view most of the items, you will need Adobe Acrobat on your computer. If you cannot open a PDF file, then your computer does not have the Adobe Acrobat software. Acrobat Reader is available free from Adobe. Download Adobe Acrobat Reader
Scam Alert!
The
Centers for Medicare & Medicaid Services (CMS) warns seniors and
people with disabilities to be aware of any schemes that ask Medicare
beneficiaries for money and checking account information or Social Security numbers to help them
enroll in a Medicare Prescription Drug Plan.. Consumers
can report these cases to their local law enforcement agencies or
1-877-7SAFERX (1-877-772-3379).
This information is distributed through the collaborative efforts of the Virginia Department of Medical Assistance Services, the VICAP program through the Virginia Department for the Aging, SeniorNavigator.org, The Centers for Medicare and Medicaid Services, Novartis Pharmaceuticals Corporation and the Social Security Administration.
Source: Centers for Medicare & Medicaid Services
Last Review: Thursday, June 03, 2010
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