Re: [QUAD-L] Fwd: Marci's Medicare Update: Week of 10/17/05--Medicare Prescription Drug Co...

[David K. Kelmer]

Hi Dana,

 

My understanding is that if you have Basic Medicare, you would look for a "stand alone" Part D Plan (PDP).  These plans will vary from company to company somewhat in what meds they will cover.  The Premiums look like they will be up to about $40 depending on the plan.

 

With Love,

CtrlAltDel aka Dave
C4/5 Complete - 29 Years Post
Texas, USA

[EMAIL PROTECTED] wrote:

FYI after I read I was still confused about prescription coverages.
Dana

To: "Dana Wray" <[EMAIL PROTECTED]>
Date: Mon, 17 Oct 2005 14:51:07 -0700
Subject: Marci's Medicare Update: Week of 10/17/05--Medicare Prescription Drug Coverage
From: "Marci / Medicare Rights Center" <[EMAIL PROTECTED]>

www.medicarerights.org  |  e-newsletters

Volume 4, Issue 42: Week of October 17, 2005 Welcome to Dear Marci, a free, weekly newsletter designed to keep you in the loop about health care benefits, rights and options for older Americans and people with disabilities. Dear Marci is a service of the Medicare Rights Center (MRC) (www.medicarerights.org), the nation's largest independent source of health care information for people with Medicare.  A national nonprofit founded in 1989, MRC helps older adults and people with disabilities get good, affordable health care.    For reprint rights, please contact [EMAIL PROTECTED]. Call MRC’s new Rx Hotline for Professionals at 877-Rx-HELP-0 for help with the new Medicare prescription drug benefit!  Information below. Topic of the Month: Medicare Prescription Drug Coverage Marci's Mailbox * * * * * * * * * * * * Dear Marci, I already have prescription drug coverage through a private company that works with Medicare. How will the new Medicare prescription drug benefit change that?      –Michael (Phoenix, AZ)   Dear Michael, It depends on how you are currently receiving your prescription drug coverage. If you currently receive drug coverage through an insurance company approved by Medicare, you either have a Medicare supplemental policy with drug coverage (Medigap), or you are enrolled in a Medicare private health plan that is providing all of your Medicare benefits (like an HMO or PPO). (If you have drug coverage through employer or retiree insurance, a state prescription drug assistance program or a long-term care facility, stay tuned for future issues.) Starting in January 2006, there are two ways you can get the new Medicare prescription drug benefit: 1. A stand-alone Part D Plan (PDP).  A "stand-alone" plan only offers prescription drug benefits. You will continue to get all your other medical services (such as doctors’ visits, hospital stays) through Original Medicare. 2. A! Medicare private health plan, also called Medicare Advantage. You can join or remain in a Medicare private health plan that provides all your Medicare-covered services, including prescription drug coverage. If you are now enrolled in a Medicare Advantage plan (HMO, PPO, PFFS), you will get a letter from your plan this fall telling you how your plan benefits and costs will change in 2006. If you want Medicare drug coverage and your plan will offer Medicare drug coverage in 2006, you can stay in your plan without taking any action. your plan will not offer drug coverage in 2006, you must choose another Medicare private health plan offered by the same company or another company with Medicare drug coverage; drop your plan and enroll in a stand-alone drug plan and get the rest of your Medicare benefits through Original Medicare; or if you are in a PFFS or cost plan (HMOs that were in effect before 1997), you can keep the plan and enroll in a stand-alone drug plan that provides your drug coverage. If you have a Medicare supplemental insurance policy (Medigap) that includes drug coverage, you are probably better off with Medicare prescription drug coverage. The new benefit will be better than the limited drug coverage provided by Medigap plans H, I and J. However, some plans in Minnesota, Massachusetts and Wisconsin, as well as some older “prestandardized” Medigap policies, may have coverage that is at least as good as or better than Medicare drug coverage (“creditable coverage”), which means you will not have to pay a premium penalty for late enrollment. Sometime before November 15, 2005, your Medigap company should send you a letter informing you if you current policy is at least as good as Medicare’s. If your policy is and you are happy with it, you do not need to do anything. If it is not, consider one of the following courses of action by May 15, 2006: Cancel your existing Medigap policy, switch to another Medigap policy that does not offer drug coverage (A-G, K or L) and enroll in the Medicare drug benefit. You are probably better off with the new Medicare prescription drug coverage than with the limited coverage offered by these plans. In most cases, you can enroll in another Medigap policy offered by your Medigap insurer, regardless of your health as long as you apply within 63 days after your Medicare drug coverage starts. You cannot be charged more because of previous or current health problems, and a pre-existing condition exclusion cannot be applied to you. (Some states offer better protections. Call your state Insurance Department for more information.) Keep your current policy but ask the company to drop the drug coverage portion of the policy and enroll in the Medicare drug benefit. Find out what the premium will be for these policies in 2006 and keep in mind that the premiums for these Medigap policies will probably increase faster than Medigap policies that never offered drug coverage. Cancel your existing Medigap policy and join a Medicare private health plan (Medicare Advantage) that includes Medicare drug coverage. You will not need a Medigap policy because it cannot pay premiums or coinsurance for Medicare private health plans (keep in mind that you may not have a right to buy a Medigap policy again later). Keep your current Medigap policy and choose not to enroll in the Medicare drug benefit. If later you want to drop the Medigap drug coverage and enroll in the Medicare drug benefit, you will have to pay a premium penalty. Stay tuned next week to learn about what happens to your retiree or employer prescription drug coverage when the Medicare drug benefit begins!       –Marci      Have a question for Marci?  Click here to e-mail your questions.  Please include your city, county and state of residence.   Spotlight on Resources * * * * * * * * * * * * For more information about what happens to your current Medicare private health plan or Medigap policy when the new drug benefit begins, see questions 76 and 77 in the Medicare Rights Center’s “Medicare Drug Coverage 101 .” Want to find out about Medigap options available next year? Check out the Medicare Rights Center’s comparison chart “Medigap Plan Benefits 2006” to see how the benefits for plans A-J—along with the two new plans K and L—match up in a side-by-side comparison. Using the Medicare Personal Plan Finder, find out about 2006 Medicare Advantage plans and Medigap supplement policies available in your area by answering a short number of questions. This dynamic search tool does not include stand-alone Medicare prescription drug plans—you can find this information using the Medicare Prescription Drug Plan Finder tool that was launched today. Thinking about joining a plan? Before checking out your local plan options, read the Medicare Rights Center’s “How to Compare Medicare Prescription Drug Plans.” Call your State Health Insurance Assistance Program for more information on Medicare benefits, rights and options. Call Social Security (800-772-1213) for questions about enrolling in Medicare. Health Tip of the Week * * * * * * * * * * * * Harvested in autumn, this round, orange piece of produce was picked for its high antioxidant levels to be profiled this month by the Centers for Disease Control and Prevention (CDC) as part of its 5-a-Day Campaign. What is it? At this time of year, pumpkin might seem like an obvious guess. And yet, while the vivid orange of the pumpkin indicates a high level of the antioxidant beta-carotene, the CDC chose to feature another item from your local market. Selected as the fruit of the month, persimmons are, like a pumpkin, another excellent source of beta-carotene, also known as Vitamin A. Also a good source of vitamin C and rich in fiber, these fruits—other than their glossy, orange color—look more like a tomato than a pumpkin though. According to the Harvard School of Public Health, current research indicates that foods containing beta-carotene may reduce the risk of developing certain types of cancer. (To reduce the risk of cancer, the American Cancer Society recommends consumption of antioxidants through food sources rather than vitamin supplements.) Beta-carotene also offers protection against heart disease and, like many antioxidants, some of the degenerative aspects of aging. Other sources of beta-carotene include carrots, sweet potatoes, winter squashes, cantaloupe, pink grapefruit, apricots, broccoli, spinach and most dark green, leafy vegetables. A good indication of the level of beta-carotene is how vivid or intense the color of the food is. For more about Vitamin A, visit MedlinePlus. Survey Says . . . * * * * * * * * * *  According to a 2005 fact sheet released last month by the Kaiser Family Foundation, participation in Medicare private health plans continues to remain well below the level it was at during the 1990’s. Today, only 12 percent of people with Medicare are enrolled in an HMO, PPO or PSO, private health plans offered by Medicare, even though 85.5 percent of people with Medicare have access to at least one of these plans. Both of these figures though are expected to spike in the coming years as Medicare private health plans play a larger role in providing benefits with the advent of Medicare prescription drug coverage—projections for 2013 enrollment range from 16 to 30 percent. Spread the Word About MARCI Tell your friends to sign up to receive Dear Marci and other Medicare policy and news updates by visiting www.medicarerights.org/subscribeframeset.html today! MRC’s Rx Hotline for Professionals 877-RXHELP-0 Need help understanding or explaining the new Medicare prescription drug benefit to your clients? Call RxHelp, a national hotline dedicated for professionals serving the Medicare population, operated from 10 a.m. to 6 p.m. EST by the Medicare Rights Center with support from the Brookdale Foundation. Dial 877-RXHELP-0 (877-794-3570) today! Feel free to forward Dear Marci to your friends or colleagues. Privacy Policy: MRC will never share your e-mail address with a third party. Contents are © 2005 by Medicare Rights Center, 1460 Broadway, New York, NY 10036.  For reprint rights, please contact [EMAIL PROTECTED].

 

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