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MEDICARE PRESCRIPTION DRUG COVERAGE - PART D
Important dates to remember -
October 2005 You should receive by mail the Medicare & You - 2006 Handbook.
November 15, 2005 The enrollment period begins for Part D.
January 1, 2006 Medicare Prescription Drug Coverage Begins for those enrolled.
May 15, 2006 Enrollment Period without penalty ends but remember, coverage
begins after you enroll and there is no benefit to delay enrolling. If you
change your mind about the plan you selected, it is my understanding
that you may change once before the enrollment period ends plus each
November 15 you will have the opportunity to change your selected plan.
If you are a Medicare Beneficiary because you are age 65 or older or you qualify because of
disability, you will soon need to make a decision regarding the new Medicare Prescription Drug
Coverage - Part D.
Following is information intended to help you make the best decision for your situation so you
can select the right Medicare - approved plan that fits your need.
First, select from the following list the situation that best describes you.
1. You are currently enrolled in Medicare Parts A & B and have no other medical insurance
other than maybe a Medicare Supplement (Medigap) Plan A thru J.
2. You are currently enrolled in Medicare but have elected to participate in a Medicare
Advantage Plan available in your area that includes coverage for prescription drugs.
(Like Secure Horizons in the DFW area)
3. You are still working and participate in a group medical plan at your company that
provides prescription drug benefits and you are also enrolled for Medicare Parts A & B or
just Part A, because your group medical plan pays primary and you have postponed
enrolling in Part B.
4. You are retired and your former employer or union provides a group medical plan
including prescription drugs that supplements your Medicare Parts A & B.
Now, go to the numbered paragraph below that corresponds to the above number you selected
as best describing your situation.
1. You may select one of the stand-alone prescription drug plans available in your area or
you may consider changing to a Medicare Advantage Plan that includes coverage for
prescription drugs, assuming one or more of this type plan becomes available in your
area. Remember, that the prescription drug coverage may vary by the organization
providing the plan, except that each plan must cover at least the same benefits defined in
Medicare's standard plan with regard to access to medically necessary drugs and
convenient pharmacies. Part D monthly premiums will also vary by plan, primarily
because of additional benefits that may be provided in the prescription drug coverage.
2, If you are happy with your choice of a Medicare Advantage Plan and the included
prescription drug coverage qualifies as "creditable" coverage (Which means it is at least
as good as the coverage available under the new Medicare Prescription Drug Coverage -
Part D), then no other action is necessary unless you want to consider other Medicare
Advantage Plans that may become available in your area.
3. Your employer is required to provide you with a notice stating that the prescription drug
coverage provided by your plan is either "creditable" or "not creditable". If creditable,
then no other action is necessary, however, your employer may have the option to
discontinue prescription drug coverage, in which case you would need to choose a
stand-alone prescription drug plan available in your area.
4. If your retirement medical plan continues to provide prescription drug coverage that is
"creditable" then no further action is necessary, However, if the drug coverage is "not
creditable" or the prescription drug benefit of your retiree plan is discontinued, you will
need to choose a stand-alone prescription drug plan available in your area.
Other important information that you should remember.
1. Do not confuse Medicare Part D with Medicare Supplement plan D. Remember that
Medicare Supplement plans include standardized Medicare Supplement plans A thru J.
2. Medicare is now made up of four Parts. In addition to the new Part D, there is Medicare
Part A - Hospital Insurance, Medicare Plan B - Medical Insurance, Medicare Part C -
Medicare Advantage Plans previously called Medicare + Choice plans. Medicare
Advantage Plans include the following type plans.
a. Managed Care, sometimes referred to as an HMO Medicare alternative,
b. Preferred Provider Organizations Plans or PPO plans that are a Medicare alternative,
c. Private Fee-for-service plans which are also a Medicare alternative, and
d. Specialty Plans.
All these plans are described in the Medicare & You Handbook plus you can check for
the plans available in your area at the Medicare web site www.medicare.gov.
3. Beginning soon, you will begin receiving in your mailbox a tremendous amount of mail,
offering you the options available in your area by all the organization approved to provide
the new plans including Part D. My suggestion is to sort your Medicare Prescription Drug
Plan mail by the following categories.
a. Stand alone Prescription Drug Plans,
b. Medicare Advantage Plans by the types described above including a separate
category for Medicare Advantage Plan, if any, that do not include a prescription drug
benefit but require a separate stand-alone Part D plan.
4. Hopefully, this information will help you understand your options to take advantage of the
Medicare Prescription Drug Coverage available as early as January 1, 2006, assuming you do
not already have adequate and creditable coverage. Before enrolling in a prescription drug . plan, make sure your current prescriptions are included in the new plan formulary or that there
is a substitute, acceptable to your doctor. After the initial enrollment period, you will only be able
to change plans on November 15 each year with the new plan effective on January 1.
W. Forrest Veal, CLU
Veal Benefit Services Inc.
972-250-6516
Note - This information is available at web site www.vbsinsurance.com. Click on Part D Decisions.
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