Starting January 1, 2006, Medicare will offer optional prescription drug plans (PDPs) to help you pay for the prescriptions
you need. Medicare PDPs will be offered by insurance companies and other private companies approved by Medicare. You can choose and enroll in the PDP that meets your needs.

When can I sign up?

Open enrollment is from November 15, 2005 to May 15, 2006. Like other insurances, you will pay a monthly premium (the average is between $20 - $40, some higher and some lower) and pay a share of your prescription costs. If you enroll after May 15, 2006, you may pay a monthly late fee, in addition to your monthly premium .

What if I already have coverage for prescription drugs?

If you already have prescription drug coverage, your current coverage must send you a Notice by November 15, 2005 to let you know if your coverage is CREDITABLE. CREDITABLE means that the coverage is as good as or better than Medicare Part D coverage. If you have CREDITABLE coverage and choose to keep it rather than enroll in Medicare Part D, you can switch to Medicare Part D in the future without paying late enrollment fees.

How much will it cost me?

Here's how the basic benefit works. Some PDPs might be more generous than this:

If your yearly income is less than $14,595, you may be eligible for assistance with your Drug Plan costs. Ask a staff person for more info.

My potential yearly costs:

• You will pay a monthly premium, likely between $20-40.
• You will pay the first $250 in annual drug costs. This is called a $250 deductible.
• You will pay 25% of your next $2,000 in annual drug costs, so the program pays up to $1,500 and you pay up to $500.
• After $2,500 in annual costs, the pogram pays nothing, and you pay all the next $2,850 in drug bills.
• After $5,100 in drug bills, benefit protection kicks in. The program pays 95% of drug costs above $5,100 and you pay 5%.

Total $3,840-$4,80+

How do I pick a Prescription Drug Plan (PDP)?

You should choose the best PDP which meets all of your needs. You can change your PDP once a year during the open enrollment period. All PDPs will have to provide at least a standard level of coverage, which Medicare will set. Callen-Lorde’s Health Education Resource Center will have a list of the PDPs and the medications they cover when that information becomes available.

 

Consider these questions about which PDP to choose:

Does the PDP cover the medications I take?

Does my pharmacy accept the plan?

How much is the monthly cost for this plan?

How do I get my prescriptions renewed at Callen-Lorde?
Nothing will change about the way you get your prescriptions from Callen-Lorde. We still partner with PharmaCare Specialty Pharmacy on 8 th Avenue and 16 th Street, and we can fax or call in your prescriptions directly to PharmaCare if you prefer. PharmaCare offers home delivery of medications at no extra cost to you.

 

Where do I get more information?

There is a lot of information available about Medicare Part D at the following websites:

Department of Health and Human Services

The Facts about Medicare Prescription Drug Plans

Centers for Medicare and Medicaid Service

The Center for Medicare Advocacy, Inc.

AARP

USA Today

You can also access more information at Callen-Lorde’s Health Education Resource Center or pick up some of the more extensive handouts Callen-Lorde has available at the Benefits Information table in the lobby. You can also ask a Callen-Lorde staff member for assistance.

(Information subject to change) updated 10/20/05