Posted: 12/12/06
Medicare Part D prescription deadline December 31
By Barb Jilk
Semcac Senior
Caregiver Advocate
The 2007 enrollment period for the Medicare D Prescription Drug Plan is from November 15 to December 31.
To ensure coverage on January 1, 2007, it is best to enroll by December 15. Enrollment is open now for people on Medicare who had no plan in 2006, or those who want to change their existing plans. People new to Medicare may enroll in Medicare and/or Medicare D in the 7 month period including their birth month, and the three months before and after that. A person born in December, for instance, can enroll anytime from September through March. His coverage will always start in the month he turns 65 if he enrolls before that month.
The Center for Medicare and Medicaid Services recommends that everyone with a Medicare D plan re-evaluate his coverage annually. The plan that just suited someone in 2006 may not be the best one for 2007. This is important because existing Medicare D plans have changed their premiums, deductibles and formularies (drugs covered by the plan) for 2007. There will be several new companies offering prescription drug coverage in Minnesota for 2007. Always check to make sure your pharmacist accepts the plan you choose, and that he will still carry in 2007 the plan you have for 2006.
The ìdonut holeî is a gap between $,2,400 (up from $2,250 in 2006), and $5,300 in total drug costs where many plans provide no coverage at all. Anyone with total drug costs of more that $200 per month will reach the donut hole in 2007 unless he or she qualifies for special help with Medicare D or is in a program such as Medical assistance.
Some plans do provide help in the donut hole. They usually have higher premiums, but may save money for some people. Many plans which covered brand name drugs in the donut hole in 2006 will cover only generics in 2007. This means that some people, especially those who have started taking expensive name brand drugs recently, may have to change medications or pay more unless they switch plans.
Special help is available for single people with incomes below $14,700, or $19,800 for a couple. Assets must be $10,000 or less for an individual or $20,000 for a couple. An extra $1,500 per person is allowed if that money is to be used for burial and funeral expenses. A special application must be filled out to get this benefit. People who qualify for special help may have no premiums or deductibles and co-pay for prescriptions as low as $1 or $3.
Medicare D is extremely confusing and frustrating for most people. Fortunately, there are several ways for people of all income levels to access free assistance making Medicare D decisions, applying for special help, comparing and choosing plans, and enrolling in a plans.
Telephone assistance in choosing a plan or enrolling on line is available to seniors, people with disabilities and their representatives or caregivers by calling the Senior Linkage Line at 1-800-333-2433.
Senior/Caregiver Advocates are the outreach arm of the Senior Linkage Line. They can arrange local office or home visits to older adults and their families or to younger Medicare ñdisabled adults to help them with Medicare D and other issues.
The Advocate for Houston and Fillmore Counties is Barb Jilk at Semcac in Rushford (507 864-8225 ; barb.jilk@semcac.org). Barb or the Senior Linkage line can provide contact information for advocates in other counties in Region 10.
All Linkage line and Advocacy staff receive Minnesota State Health Insurance Program Training on Medicare D and other health insurance programs from the Minnesota Area Agencies on Aging and the Department of Human Services.
Medicare offers on-line Low income subsidy help, as well as plan comparisons and enrollment at www.medicare.gov and telephone assistance at 1-800-MEDICARE (633-4273).
Caledonia Argus
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