How will I be affected by the Medicare prescription drug policy?
What do I need to do?
This section will guide you step-by-step in your decision whether to sign up for the new Medicare prescription drug policy. Since people have many different situations, we have a number of options below. Please find the solutions that best apply to you.
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The first question to consider is,
Do you have coverage right now for prescription drugs?
Click the correct answer: YES or NO
YES, I have prescription drug coverage.
(If your answer was NO, please skim ahead to find that heading.)
Be aware that your coverage may change under the new Medicare laws.
Consider the next questions that narrow down where your current coverage comes from. Each situation requires you to take different steps.
Does your prescription drug coverage come from…
1. …a Medicare Advantage Plan or other Medicare Health Plan? OR
2. … a Medigap (“Medicare Supplement Insurance”) policy? OR
3. … your state Medicaid program? OR
4. … your (or your spouse’s) employer or union? OR
5. … TRICARE or the Department of Veteran’s Affairs (VA),or the Federal Employee Health Benefits Program (FEHB)?
Review the responses below to find the one that applies to you.
1. Does your prescription drug coverage comes from a Medicare Advantage Plan or other Medicare Health Plan?
Your plan will send you information about their new policies. If you don’t receive information from your insurance company, contact them. Read the information on the new policy carefully. Compare its costs (premium, copayments, etc.) and benefits with those of the Medicare standard plan. You can then choose which policy best suits your needs.
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2. Does your prescription drug coverage come from a Medigap (Medicare Supplement Insurance) policy?
Most Medigap policies, overall, are not as good as the new Medicare drug policy. Chances are you will want to switch to the Medicare prescription drug plan.
You should have already received information from your Medigap insurance company, detailing their updated prescription drug coverage. Go over this notice carefully to be sure you understand the costs and benefits. Compare them with the Medicare policy. Contact your Medigap company before you make changes to your coverage.
If you do choose to switch to the Medicare policy, be sure you sign up before May 15, 2006, if possible. You will be charged a penalty for signing up late. Furthermore, those who miss the May deadline will be required to wait until November to apply again.
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3. Does your prescription drug coverage come from your state Medicaid program?
Your Medicaid coverage for prescription drugs has changed. Now Medicare, not Medicaid, pays for your drug coverage. (Medicaid will still cover other medical care.) The last day of your old Medicaid policy was December 31, 2005.
You will have continuous prescription drug coverage. Medicare pays most of the cost of your prescription drugs. You will, in most cases, pay a small amount yourself for each prescription.
There are a range of prescription drug plans for you to choose from. Medicare chose a plan for anyone who did not select one by the end of 2005. You can still make a choice, however. Contact the Medicare office or visit the website for details.
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4. Are you covered for prescription drugs through your (or your spouse’s) employer or union?
You should receive a notice from your insurer about how your current policy compares with the new Medicare drug policy. Contact your benefits administrator if you have questions.
If your current coverage is as good as the Medicare plan, then you can keep what you have. In the future, if your insurer stops your coverage, you can join the Medicare plan with no penalty (within 63 days).
If your current insurer does NOT offer prescription drug coverage that is as good as the Medicare plan, you may sign up for Medicare coverage. If you do so by May 15, 2006, you will avoid a penalty.
Caution: Check the policies of your insurer carefully before making any changes. Dropping the prescription drug policy, may require canceling your entire policy. There are options to be sure you keep full coverage. Talk to the benefits administrator and refer to the Medicare website for assistance.
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5. Does your prescription drug coverage come from TRICARE or the Department of Veteran’s Affairs (VA), or the Federal Employee Health Benefits Program (FEHB)?
Your current coverage will not change. In most cases, you will get the best coverage by keeping what you have (rather than switching to the new Medicare plan).
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Or, Request a free Medicare Supplement quote from Health Insurance Carriers in your state >>
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NO, I DO NOT have prescription drug coverage.
Medicare now offers everyone coverage to help pay for prescription drugs. Even if you don’t use many prescription drugs at the moment, it’s wise to consider getting coverage for the future. By signing up now, you will avoid a penalty. Also, if you wait until after May 15, 2006, coverage may be delayed by as much as six months.How you sign up for coverage depends on what type of health insurance you have now.
Does your health insurance come from…
1. … a Medicare Advantage Plan or other Medicare health plan? OR
2. … the Original Medicare Plan WITHOUT a Medigap plan? OR
3. … the Original Medicare Plan WITH a Medigap policy?
Review the responses below to find the one that applies to you.
1. Does your health insurance come from a Medicare Advantage Plan or other Medicare Health Plan?
Check with your current insurance company to see if they offer prescription drug coverage. If they do, you will be required to get your drug coverage from them unless you want to switch policies. You can select another Medicare Advantage or other Medicare Health plan or switch to the Original Medicare plan and join the Prescription Drug Plan. If you want to sign up for the Medicare drug policy, you will save yourself a penalty if you sign up before May 15, 2006.
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2. Does your health insurance come from the Original Medicare Plan WITHOUT a Medigap plan?
To get prescription drug coverage, you can either sign up for the Medicare Prescription Drug Plan or you can join a Medicare Advantage Plan or another Medicare Health Plan that covers prescription drugs.
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3. Does your health insurance come from the Original Medicare Plan WITH a Medigap policy?
If your Medigap policy does not provide prescription drug coverage, you will need to switch policies in order to sign up for coverage. Contact your Medigap insurer for information. You can also choose from the policy options outlined at the Medicare website (www.medicare.gov).
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Request a free Medicare Supplement quote from Health Insurance Carriers in your state >>
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