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WHAT
IS MEDICARE PART D?
What
Are Medicare Prescription Drug Plans?
Beginning January 1, 2006, under the Medicare Prescription Drug Improvement
and Modernization Act of 2003, prescription drug plans will be available to
all seniors and people with certain disabilities who are on Medicare. All
plans have to provide coverage that at least meets the minimum standard set
by Medicare,
but plans will vary according to:
- what
drugs are covered;
- which
pharmacies you can use; and
- what
you pay for the plan’s premiums, deductibles, and prescription
co-payments.
Who
Is Covered?
If you are eligible for Medicare, you are entitled to Part D prescription drug
coverage and can sign up for a plan.
How
Much Will it Cost?
That will depend on the plan you choose. Unless you qualify for a limited income
subsidy (see below), you will pay:
1)
Monthly premiums,
2) Annual deductibles, and
3) Co-payments for each prescription.
Also,
if your drugs cost more than $2,510 in one year, you will pay
their full cost between $2,510 and $5,726.35.
What
If I Have a Limited Income?
If your income level meets certain guidelines, you may be able to get extra
help paying the costs of your prescription drug plan. For more information
about whether you qualify and how to get such assistance, call 1-800-MEDICARE
or your local Social Security office.
Where
Will I Get My Medications?
You will still be able to get your drugs from a pharmacy. Different plans will
use different pharmacies, though, so when choosing a plan, be careful to check
which pharmacies the plan uses. Some plans may also offer mail-order prescription
services.
What
Drugs Will Be Covered?
Not all drugs will be covered by every plan. It is VERY important to compare
plans to see which ones offer the drugs you use. Keep in mind:
- All
plans must offer drugs in six major categories specified by
Medicare, but they do not have to offer every drug within each
category.
- A
plan’s drug list (formulary) may not include your specific
drug, but may offer a generic or another drug that would work
just as well for you. Consult your doctor for possible substitutes.
- Plans
can change the drugs they offer frequently, although you will
only be able to switch plans once a year. Pay attention to
changes in plans so you can make the best choice for yourself
every year.
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