Medicare Part D- Frequently Asked Questions
How do I pay for the coverage? Can it be deducted from my Social Security or my retirement check?
In general, there are three ways you can pay your Medicare drug plan premiums:
1.You can give permission to the company that offers the Medicare
drug plan you choose to deduct the premium automatically from your bank account, or
2.You can have your premium deducted every month from your Social Security benefits, similar to your premiums for Medicare Part B, or
3.You can pay the prescription drug plan directly for your premium by mailing them a check or money order each month.
What if the prescription I take is not covered by my Medicare drug plan? Will Medicaid still pay for it?
If Medicare covers a prescription drug, Medicaid will not pay for it. However, Medicare drug plans do not have to cover every drug that's included in Medicare prescription drug coverage. They only have to cover every type of drug. You should review what drugs are covered by the Medicare drug plans available in your area and try to join one that covers the same prescriptions you take now. If the plan does not cover your exact prescriptions, it is required to have a transition period where your current drugs may be covered for a certain length of time while you work with your doctor to find an alternative prescription drug to take that is covered by the plan. If your doctor believes you need to take your current prescription drug and should not switch to a covered prescription drug, you or your doctor can contact your plan and ask it to give you an exception which means the plan agrees to pay for your current drug. If the plan refuses to give you an exception, you can appeal the plans decision.
However, if you are currently stabilized on certain specific prescription drugs (like drugs for depression, cancer or HIV/AIDS), you do not have to switch to a different prescription drug. Please talk to your doctor or pharmacist to see if your prescription drugs qualify.
When you join, the Medicare drug plan will send you information about its appeal procedures. Read the information carefully and call your plan if you have any questions.
What happens if I choose not to join a Medicare drug plan by May 15, 2006? Can I join later?
If you do not join a plan by May 15, 2006, and you do not currently have a drug plan that, on average, covers at least as much as standard Medicare prescription drug coverage, you will have to wait until November 15, 2006 to join. When you do join, your premium cost will go up at least 1% per month for every month that you wait to join. Like other insurance, you will have to pay this penalty as long as you have Medicare prescription drug coverage.
If you join after May 15, 2006, the next open enrollment period is November 15, 2006 to December 31, 2006. However, coverage for people who enroll during this period will not take effect until January 1, 2007.
Will I be able to use my drug store drug discount card (not a Medicare-approved drug discount card) with a Medicare drug plan?
Drug stores issuing the discount card will determine what type of discount will be applied to the drug. Generally, drug store discount cards provide a discount on the retail price of the drug not otherwise covered by a patient's insurance. Since people with Medicare will be receiving coverage for prescription drugs, further discounts may not apply.
Will I be able to use more than one Medicare drug plan?
No. You will only be able to join, and get coverage under, one Medicare drug plan at a time.
Can I use my regional drug plan all over the country?
Regional drug plans will generally only cover prescriptions from pharmacies in a particular area. (Some prescriptions may be covered in other areas in an emergency.) There will be national plans available that cover prescriptions all over the country.
What do people with Medigap policies need to do to get Medicare prescription drug coverage?
Like any other people with Medicare, anyone with a Medigap policy will need to join a Medicare drug plan if they want to get Medicare prescription drug coverage that meets their needs.
If you have a Medigap policy that includes prescription drug coverage, and you choose to join a Medicare drug plan, you should notify your Medigap insurer. If you choose to keep your Medigap policy for your other health expenses, the insurer will remove the drug coverage from the Medigap policy, and adjust the Medigap premium. In some cases, the insurer is also required to offer you a different Medigap policy that does not include prescription drugs.
A person ca not have prescription drug coverage through Medigap and through a Medicare drug plan at the same time.
Will Medicare drug plans have preferred drug lists?
Yes. A preferred drug list is a special list of drugs that your plan has determined are less costly and as effective as other drugs. The plans formulary may include preferred drugs, and you may pay less money if you use preferred drugs than other drugs on your drug plan's formulary.
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