Medicare Part D Prescription Drug Plan

Starting January 1, 2006, Medicare will offer 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.

How do I sign up for Medicare Part D?

If you currently receive Medicare and Medicaid, you will be automatically enrolled in a Medicare Part D prescription drug plan (PDP) starting late October 2005. This drug plan will replace the drug plan that you had with Medicaid. The Medicare Part D plan will begin and your Medicaid drug plan will end on January 1, 2006. There will be no gap in your drug coverage.

 

How Much Will It Cost Me?

You will have no premium and no deductible. The only expense to you will be co-payments for your drug prescriptions:

 

• If your yearly income is at or below $9,570 (or more if you are legally married or have dependent kids) you will have co-payments (out-of-pocket payments) of $1 for generic drugs and up to $3 for brand name drugs. You will pay $0 once your drug costs reach $3,600.
• If your yearly income is above $9,570 (or more if you are legally married or have dependent kids) you will have co-payments (out-of-pocket payments) of $2 for generic drugs and up to $5 for brand name drugs. You will pay $0 once your drug costs reach $3,600.

 

How do I pick a PDP?

The federal government will randomly assign you to a PDP in October or November 2005. This assignment will be random and will not be based on which medications you are taking or where you live. If the PDP to which you are assigned does not best meet your needs, you have the right to change your PDP one time per month. 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 when thinking about which PDP to choose:

Does the plan cover the medications I take?

Does my pharmacy accept the 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