A Close Look at Medicares ; Part D Program
Posted on: Wednesday, 12 October 2005, 21:00 CDT
By NOW, IF YOU ARE A PARTICIPANT IN MEDICARE, YOU WILL HAVE HEARD OF PART D, WHICH WILL BEGIN PROVID
By now, if you are a participant in Medicare, you will have heard of Part D, which will begin providing drug benefits on Jan. 1, 2006.
In essence, it is an additional insurance policy intended to give you both competitive pricing and coverage in obtaining prescription medications.
The first date for enrollment in Medicare Part D will be Nov. 15, 2005. The last date to join the plan for coverage in 2006 will be April 15.
Our area will have several PDPs, or Prescription Drug Plans, from which you can choose one. The premiums will cost between $30 to $32 per month.
These PDPs will have a formulary showing you what drugs they provide and which are excluded, so make sure you see that before signing up. Some of you may already be in a Medicare Advantage plan, which has drug coverage. Should you make the choice to be enrolled in Part D, you will not be able to keep Medicare Advantage!
After joining, your coverage will start on Jan. 1. There is a deductible of $250, so you will be required to pay that much of your initial cost for medicine. At this point, the plan will begin to pay 75 percent of your costs for the next $2,000, meaning you will pay $500 while Part D will pay $1,500.
This can be a helpful plan for those with no other insurance coverage for medications.
The down side of the plan is that once you reach $2,250 ($250 in deductible, $500 in co-payment, and $1,500 in coverage) there is a coverage gap period. This means that for the next $2,850, or a total of $3,600 of expense, there will be no coverage. At this point, the plan considers the expenses to have become catastrophic and it will pay 95 percent of costs.
Each plan can have variances such as no deductible or differences in the drugs they cover. This makes it important that you review the plans and select one that best fits your needs.
Dr. Mark Menees is the administrator of Coble Health Care of the Twin Lakes Community. Older, Wiser Living is a montly column by the staff of the Twin Lakes Community.
Source: Greensboro News Record
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