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Volume 16, Number 2 · April 2006

Medicare Part D

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The enrollment deadline for the new Medicare prescription drug benefit is May 15, yet experts believe millions of Medicare beneficiaries have not yet signed up for a plan, in part because of the complexity of the benefit and options. If your health care plan already includes prescription coverage, you need not enroll. However, if you, or someone you know, does not have adequate prescription drug coverage, you must enroll in a plan prior to the deadline. It is important to enroll prior to the May 15 deadline because failure to enroll will result in paying a penalty to enroll in the future. The initial choice of plans can be a daunting task. However, after one year in any plan you have the right to switch to another provider's plan.

The Pennsylvania Health Law Project offers these tips:

When you are comparing all the Prescription Drug Plans available to you, you should consider these questions:

Costs
  • How much is the monthly premium?

  • What is the annual deductible?

  • What co-pays will the Plan charge?

  • What will the co-pays be for the drugs I take?
Drug Coverage
  • Will the Plan cover all the drugs I take?

  • Will the Plan require that I get "prior authorization" for any of my drugs?

  • Does the Plan have any "transition policies?"
Pharmacy Network
  • Will the Plan let me use the pharmacy I go to now?

  • Is there a pharmacy near me in the network that is open 24 hours/7 days a week?

  • Can I get my drugs through mail order?

  • How do I get my prescriptions if I am out of the network? (visiting or on vacation out of state, for example)
For more information about the Plans and how to enroll:

www.medicare.gov
Call Medicare: 1-800-633-4227
PA Health Law Project
Helpline: 1-800-274-3258



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