New Medicare drug benefit explained

Moore hosts meetings to explain new Medicare drug benefit plan

From Kansas City DosMundos newspaper-
http://www.dosmundos.com/editions/Vol25-10-20/health/health-Aeng.htm


U.S. Rep. Dennis Moore of Kansas and a panel of three experts fielded questions during a forum for seniors at the Sylvester Powell Community Center in Mission, Kan., Oct. 11. It was the third in a series of public meetings Moore is hosting in his congressional district to explain the new Medicare prescription drug plan set to take effect Jan. 1, 2006.
Michelle Velasquez with Centers for Medicare and Medicaid Services gave an overview of the insurance program.

“Medicare prescription drug coverage is available to everyone covered by Medicare,” she said.
The program covers both brand name and generic drugs. Medicare recipients who are currently enrolled in a drug plan that is as good or better than the Medicare prescription drug coverage have the option of staying with their current plan. But there is a permanent premium penalty of one percent a month for enrolling after May 15, 2006.

Velasquez advises Medicare recipients to study all the available plans and consider what types of medications are covered and what pharmacies are included.
There are three ways to pay for the new Medicare prescription drug coverage: through automatic deductions from monthly Social Security benefit checks, through automatic deductions from a personal bank account, or by payments mailed directly to the company.

She said there’s a list of the programs in Kansas in the back of the new Medicare handbooks being mailed to 35 million Medicare recipients. Information on the new prescription drug coverage is available in English and Spanish on the Internet at www.medicare.gov, or by calling the speech-automated system at 1 (800) 633-4227.

Veterans who currently have prescription drug coverage from the Department of Veterans Affairs will not lose their benefit because of this new program. If they ever lose their V.A. coverage, they could enroll in the new Medicare prescription drug program within 63 days without paying a premium penalty.

Medicare beneficiaries are not obligated to enroll in the Medicare prescription drug program.
John Garlinger with the U.S. Social Security Administration talked about extra help for low-income beneficiaries under the new plan. He urged people to apply for help paying for the annual deductible, premiums and co-payments for the Medicare prescription drug coverage. He said there’s no risk in applying to determine eligibility, which is based on an income test and a resources test.
Single seniors with an annual income of less than $14,355 and couples with a combined annual income of less than $19,245 may be eligible for extra help.

The resources test is based on bank account balances, stocks and bonds. The value of homes and cars is not considered. Senior singles with resources under $11,500 and married seniors with combined resources of less than $23,000 may be eligible for extra help. Medicare beneficiaries can apply for extra help on the Internet at www.socialsecurity.gov, by calling 1 (800) 772-1213, or in person at a Social Security office.
Katy Lamm with Senior Health Insurance Counseling of Kansas addressed how to get help enrolling in the program.

“No one should charge you for information on the various drug plans,” she said.
Senior Health Insurance Counseling for Kansas sponsored by the Johnson County Area Agency on Aging at (913) 477-8131 has trained counselors available to meet with Medicare beneficiaries to explain the new program, review the various plans, and help beneficiaries assess their health insurance needs.

The new Medicaid prescription drug program, Part D is offered by multiple private providers. Each offers assorted coverage options and premium rates. Each plan has a government-approved list of drugs, or formulary it covers, which can vary from plan to plan.

There are two basic types of plans: a simple prescription drug plan (PDP), which only covers drugs and can be used with Medicare and/or a Medicare supplement plan; a Medicare Advantage plus Prescription Drug plan; or MA-PD, which offers medical coverage for doctor visits and hospital expenses. The enrollment period for coverage beginning on Jan. 1 starts Nov. 15.

A crowd of more than 400 people who gathered at the community center with a seating capacity of 150 prompted Moore to arrange for a second forum immediately afterward and schedule a fifth program to be presented at Village Presbyterian Church in Prairie Village at 2 p.m. Oct. 24.