Reprinted from the Health District's quarterly publication mailed to district residents (Fall 2005)

What if I have prescription drug coverage from a former or current employer?

If so, you should talk to your plan/benefits administrator or insurer before making changes. Plans offered through employers or other third parties are required to notify you whether your plan is at least as good as Medicare’s plan. If your current plan is better, you can keep it as long as it is offered. If your employer stops offering drug coverage, you will not have to pay a penalty as long as you join a Medicare drug plan within 63 days after coverage ends.

Caution: If you drop your employer coverage, you may not be able to get it back. Also, you may not be able to drop your employer drug coverage without also dropping your health coverage.

Should I join a Medicare drug plan even if I don’t take many prescription drugs?

If you have Medicare, you should still consider signing up for the Medicare drug plan. As people age, most will need prescriptions to stay healthy. If you do not have a private prescription drug plan and choose to sign up after the May 15, 2006, deadline, your premium costs per month will go up every month that you waited to join.

What does a Medicare drug plan cover?

The plans will cover generic and brand-name drugs but plans may have rules about what drugs are covered in different drug categories.

What is “extra help” and how do I know if I qualify for it?

People who meet income guidelines may qualify for “extra help” paying their Medicare drug plan costs, including help with premiums, deductibles and copayments. You may qualify for extra help if your income is less than $14,364 for an individual with assets of less than $10,000, or $19,248 for a married couple living together with assets of less than $20,000. Assets include cash, savings and investments but not car or home. The Health District’s Prescription Assistance program can help you find out if you qualify. Call 472-0444. You will need to fill out an application for extra help. You can also contact the Social Security Administration’s local office for assistance with “extra help” at 482-5130, ext. 206.

What do I need to know if I have a Medigap (Medicare Supplemental Insurance) policy that covers prescriptions?

This fall, you should get a detailed notice in the mail from your Medigap insurance company describing your choices for prescription coverage. Most prescription coverage through Medigap policies, on average, is NOT at least as good as Medicare prescription coverage. You will want to look at your Medigap coverage closely. Keep in mind, if you choose not to apply for Medicare prescription coverage by May 15, 2006, you will have to pay a penalty if you choose to join later. Starting Jan. 1, 2006, the option of buying a new Medigap policy that covers prescriptions will no longer be available.