| Medicare Part D: What's it to me? by Paul Kusuda |
| It's a voluntary program for most people, but those receiving Medicaid benefits automatically become enrolled through federal action. Others, including those who were both Medicare-eligible and receiving prescription drugs through Medicaid, are also automatically enrolled. Persons who are not yet 65 or not otherwise eligible for Medicare will have an enrollment period that begins three months before becoming eligible. The current enrollment period began October 1, 2005 and will end May 15, 2006. Eligible persons who do not enroll by the end of the enrollment period will suffer a huge penalty that increases each month. That penalty is one percent per month on top of the monthly cost of having Part D coverage. As an example, if the cost (depending on the plan selected) is $30 and a person delayed 10 months before enrolling, the monthly cost would not be $30; it would be $33. The longer one waits, the higher the monthly premium. So, what's it to me? Well, if I'm Medicare eligible and already enrolled in Parts A and B but not in Part D, I'd have to give the program a good think. If I'm not eligible, I might find it worthwhile to find out about the program before deciding whether or not to opt into the program. One major consideration overlooked by many who might feel a kind of a panic because of the one percent penalty aspect is that if they are currently in some kind of a plan with prescription drug coverage, they may be exempt from that penalty and may enroll in Medicare Part D at a later date. If the drug coverage is equal to or better than the Part D program, it will be considered "creditable coverage," and the exemption will apply. Each person who has "creditable coverage" should have written documentation from the current provider that states that fact. The Medicare Part D Prescription Drug Program was part of the Medicare Modernization Act passed by Congress and signed by the President in 2003. Many senior advocates, including the Coalition of Wisconsin Aging Groups (CWAG), actively opposed that Act, but political arm-twisting resulted in the Congressional action. In 2004, CWAG began to let seniors know about Part D, what it is, and what it is not. One heck of a lot of work took place. Presentations were made to various groups, not just those attended by the aged. Part D is extremely complex, confusing, and has gaps in coverage. For many, the costs are much higher than currently-held plans. Deductibles and copays may be higher. The penalty angle frightens many into taking action that may well be unwise and costly. SeniorCare Program Wisconsin's SeniorCare Program gives prescription drug coverage to state residents 65 years and older who meet income requirements. It's a program jointly financed through federal and state funds. At present, federal funding will continue through June 30, 2007. Efforts to continue federal funding beyond that date are an ongoing effort by Wisconsin's public officials, including the governor and his staff and our Wisconsin delegation in Congress. Wisconsin SeniorCare is superior to Medicare Part D; therefore, it is "creditable." That means that as long as a person has SeniorCare, there can be no penalty for Medicare Part D enrollment after the period expires. Even though Wisconsin SeniorCare has certain income requirements, anyone may join for the sum of $30 per year whether or not the prescription drug coverage is used. In other words, persons whose incomes exceed the requirements may not benefit directly from the program; however, since it is "creditable" as already decided by authorities, SeniorCare members can delay decisions about Medicare Part D as long as they continue membership. Anyone interested in enrolling in SeniorCare may get application information from the Wisconsin Department of Health and Family Services by calling SeniorCare at 1-800-657-2038. That information will not only explain the income requirements but also show you how easy it is to enroll. Medicare beneficiaries in Wisconsin wanting help in evaluating their specific prescription drug options can get free counseling advice by calling 1-866-456-8211 (toll free). They may also get help from benefit specialists in their county or tribal areas. The Benefit Specialist Program is a federal- and state-mandated advocacy program to provide free legal services. To be eligible, a person must be at least 60 years old. The program assures free legal services for older adults. In Dane County, a benefit specialist may be reached at the Coalition for Wisconsin Aging Groups, Elder Law Center, at (608) 224-0606. By the way, anyone may become a member of CWAG for $15 per year. Age is not a requirement for joining an advocacy organization that is intergenerational in focus. Group memberships are also welcome; the cost is a modest $25 per year. Elizabeth Conrad, CWAG Medicare Integrity Project Director, announced that the National Alliance for Hispanic Health created a bilingual hotline for assistance with the Medicare Part D enrollment process. The toll-free number 1-866-783-2654 is available Monday-Friday from 8 a.m. to 6 p.m., Eastern Standard Time. The National Asian Pacific Center on Aging has established a toll-free multilingual helpline for English-, Korean-, Chinese-, and Vietnamese-speaking persons. The numbers are as follows: English, 1-800-582-4218; Korean, 1-800-582-4259; Chinese, 1-800-582-4218; and Vietnamese, 1-800-582-4336. I haven't tried any of these numbers; but I hope they're correct. |
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| How does Medicare Part D affect me? Why should I care about it? For those eligible for Medicare by being a person 65 years of age or older or by having disabilities, it's additional health care coverage beyond Part A (hospital costs) and Part B (outpatient costs). |
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| to March '06 preview |