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Long Island's Elder Law, Special Needs & Estate Planning Firm

Thursday, August 18, 2005

Medicare Part D - Part 2

What happens if I have Medicaid?
If you currently have Medicaid, you will lose your Medicaid prescription drug coverage on January 1, 2006 and will automatically be enrolled in a new plan through Medicare. In October 2005, letters will be mailed out to Medicaid recipients alerting them which plan they will be enrolled in if they do not choose one by December 31, 2005. In order to make sure that your drugs will be covered, you should select a plan that suits your needs.

What about my Medigap plan?
Starting January 1, 2006, any person enrolled in Part D cannot buy or renew Medigap plans H, I, and J. If you have a Medigap H, I, or J plan and want to keep its prescription drug coverage, you cannot enroll in Part D. But, if you choose to later enroll in a Part D plan and lose your Medigap drug coverage, you will be charged a penalty premium. If you want to keep your Medigap plan and enroll in Part D, your Medigap plan will be modified to exclude prescription drug coverage after Part D becomes effective and your premium will be modified accordingly.

Can I supplement my Part D drug coverage at all?
Yes, individuals who enroll in Part D prescription drug coverage can still supplement their coverage from other sources. Supplemental coverage can either offer more comprehensive coverage than Medicare or it may choose to wrap around the Medicaid Part D benefit and help with cost sharing. One option is help through a state pharmacy assistance program (such as EPIC in New York). Employers and unions can also choose to help with supplemental coverage as well.

What about my Medicare discount prescription drug card I have?
The Medicare discount card program will be phased out once the Part D prescription drug benefits begin. The program will be discontinued either when your Part D plan takes effect or at the end of the initial enrollment period on May 15, 2006, whichever comes first.

When and how can I sign up?
There is a six month initial enrollment period starting on November 15, 2005 and continuing until May 15, 2006. If you enroll before or on December 31, 2005, your new plan will start on January 1, 2006 and you will see no lapse in coverage. If you choose to enroll after January 1, 2006, your plan will start on the 1st of the following month. You can currently apply for low income assistance either through Social Security (www.ssa.gov) or through your state Medicaid office. To enroll in a Part D plan, you will apply directly to Medicare (www.cms.gov) but can only apply once the enrollment period begins.

What should I do?
Since Medicare Part D is new, there are still many uncertainties regarding changes in coverage. It is advisable to speak to a knowledgeable Elder Law attorney aware of all the intricacies of Medicare law in order take full advantage of the new Medicare drug coverage.

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