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Medicare part D prescription drug sign-up ends December 31
Medicare beneficiaries have from November 15 until December 31 to select their Part D prescription drug plan for 2008. These plans provide varying Medicare coverage of prescription drugs. Q.: How can I compare plans? A.: To compare plans, you should make a list of all your current medications including name, dose size, dosage frequency, and monthly cost. The list of drugs a plan covers can be obtained by calling the plan, visiting the plan's Web site, or visiting www.medicare.gov. You can also call the Ohio Senior Health Insurance Information Program (OSHIIP) at 1-800-686-1578 for free, personalized health insurance counseling. If you have your Medicare card, a list of drugs used, and the name of your pharmacy, you may call Medicare directly at 1-800-633-4227. The information that OSHIIP or Medicare has occasionally differs from the plan's actual benefits, costs, and covered prescriptions. Therefore, beneficiaries should confirm the information from OSHIIP or Medicare with the plan itself and then enroll directly with the plan. Q.: What if I get on a plan and then want to change it? A.: Most people cannot change plans after the annual enrollment period. You may change your plan if you enter a nursing home or move to a location not covered by your plan. People eligible for Medicare and Medicaid and people enrolled in a Medicare Savings Program may change plans monthly. Otherwise, you must wait until the 2009 enrollment period from November 15 through December 31, 2008. Q.: What must I pay for my drug plan? A.: In 2008, for drugs covered by your plan, you must pay a monthly premium that varies from plan to plan, as well as the first $275 for prescriptions. The monthly premiums and the cost of medications not covered by the plan do not count toward the $275 yearly deductible. In 2008, you pay the $275 deductible and then 25 percent ($558.75) of the next $2,235 cost of drugs. You then pay 100 percent of the next $3,216.25 cost of drugs. After you reach this $4,050 catastrophic limit on out-of-pocket expenses ($275 + $558.75 + $3,216.25 = $4,050), you pay $2.25 for generic prescriptions and $5.60 for brand-name prescriptions. Q.: Do I have to have a Medicare drug plan? A.: No. Whether to join a Medicare drug plan is your choice. For most people, joining as soon as they are eligible means they will pay the lowest possible monthly premium. However, if you already have prescription drug coverage, your or your spouse's former or current employer or union must send information about how your current coverage compares to the Medicare standard prescription drug coverage. If the employer or union determines that the coverage is at least as good as Medicare's standard prescription drug coverage, you can keep it as long as the employer or union offers it. Assuming you wish to receive Medicare drug coverage, you must enroll in a Part D plan during the month in which you become eligible or you will incur a penalty. If you wait to enroll, your monthly premium cost will go up at least one percent per month for every month that you waited to join. For example, if you do not enroll for 20 months after you become eligible, your monthly premium will be 20 percent more than if you had enrolled when you first became eligible. This penalty continues to rise at the rate of at least one percent per month until you do enroll. For example, if you wait ten years to enroll, you will pay a surcharge of approximately 120 percent. Q.: My father is now in a nursing home. Must he pay for Part D coverage? A.: No. Institutionalized individuals eligible for Medicare and Medicaid pay nothing for Part D coverage. Non-institutionalized individuals eligible for Medicare and Medicaid pay $1.05 for generic prescriptions and $3.10 for brand-name prescriptions. If your father's Medicare deductibles and co-payments are paid by Medicaid, he would pay $2.25 for generic prescriptions and $5.60 for brand name prescriptions, provided his countable resources are less than $6,120 (or $9,190 if he is married). If his countable resources are less than $10,210 (or $21,410 if he is married), he would pay a 15 percent co-payment for his prescription drugs after paying a $56 yearly deductible. Law You Can Use is a weekly consumer legal information column provided by the Ohio State Bar Association. This article was prepared by Gregory S. French, a certified elder law attorney in Cincinnati. Articles appearing in this column are intended to provide broad, general information about the law. Before applying this information to a specific legal problem, readers are urged to seek advice from an attorney.
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