Kathleen G. Kane - Pennsylvania Office of Attorney General - Protecting Pennsylvanians

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ASK THE ATTORNEY GENERAL: How Will The New Medicare Prescription Drug Coverage Affect Me?

The Medicare Prescription Drug, Improvement and Modernization Act of 2003 created a new Medicare Part D benefit that will provide prescription drug coverage to Medicare beneficiaries.  Starting January 1, 2006, new Medicare prescription drug coverage will be available to everyone with Medicare.  This drug coverage may help lower out-of-pocket prescription drug costs and help protect you from higher costs in the future. 
Please be aware that no one can enroll you in a plan before November 15, 2005.  Any marketing materials that you receive should contain the Medicare-approved seal.  Be especially aware of solicitations that look like they are affiliated with the government but are not.

What if I already have prescription drug coverage?

If you already have prescription drug coverage, you should talk to your plan manager, benefits administrator, or insurer before making any changes.  You should receive a notice about any changes in your current coverage so you can decide if you should join a Medicare drug plan.

What types of benefits will Medicare Part D cover?

Each prescription drug plan will cover different drugs.  It is up to you to choose the one that will be most beneficial to you and your family.  The standard coverage will include a monthly premium, a deductible, and a portion of your prescription drug costs or a co-payment paid by you.

How will the coverage be marketed?

Private insurance companies may market their Medicare Part D programs by mail, internet, and telephone.  It is important to remember that they cannot enroll you in a plan before November 15, 2005.  If you're asked, never give out a bank account, credit card account, Social Security number or any other personal information.  
What if I'm retired and I think my current plan is better?

If you are a retiree with prescription drug coverage through your former employer, the company is required to notify you by November 15th as to whether your current coverage is better than the standard Medicare Part D benefit.

Are there any tips to consider when choosing a Medicare Part D prescription drug plan?

When you're trying to choose the plan that is right for you make sure that:

  • You request written information about the plan and review it carefully.
  • The prescription drugs you are currently using are covered by the plan and that you can afford it.
  • You are not pressured into signing up with a plan.
  • You look for the Medicare-approved seal on all prescription plan marketing materials - be alert for program names or logos that look like they are from the government but are not.
  • Companies do not try to enroll you over the telephone.  They cannot enroll you in a plan over the telephone or ask you to pay over the telephone unless you are adding prescription coverage to a health plan you already have with that company.
  • You do not buy a plan from someone who comes to your door unsolicited. Medicare Part D plans cannot be sold door to door.
  • You do not give out your Medicare or Medical Assistance number to anyone.

How should I compare Medicare drug plans?

There are many factors you may want to consider when comparing your Medicare drug plan choices. These factors include

  • Coverage - Medicare drug plans will cover generic and brand-name drugs.
  • Cost - Monthly premiums and your share of the cost of your prescriptions will vary depending on which plan you choose.
  • Convenience - Drug plans must contract with pharmacies in your area.
  • Security - Even if you don't take a lot of prescription drugs now, you still should consider joining a drug plan in 2006.

It is important to remember that your pharmacist can be a great resource when evaluating which Medicare Part D plan is best for you.  You can also obtain additional information, and even compare the plans being offered in your area, by visiting www.medicare.gov.  Additional information can also be obtained by contacting APPRISE at 1-800-783-7067 weekdays from 9 a.m. to 4 p.m.

The Health Care Section is investigating complaints from consumers who claim to have been deceived into joining plans that they thought were government sponsored.  Please make sure that the plan you are interested in is legitimate.  If you still have questions or need more information contact the Attorney General's Heath Care Section by calling 1-877-888-4877 or visit www.attorneygeneral.gov.