Take time and prepare, says Medicare

The Medicare prescription drug benefit’s six-month open-enrollment window begins Nov. 15. Until then, the Medicare agency is advising beneficiaries to take their time and prepare by identifying how they currently get drug coverage (if any).

This will help beneficiaries simplify their decision, say Medicare officials. Veterans already enrolled and covered for prescription drugs under the Department of Veterans Affairs (VA), for example, are advised by the Medicare agency to remain with what they have.

Medicare advises beneficiaries to identify which of the following categories applies to them:

• No prescription drug coverage

Medicare prescription drug coverage will likely help with drugs costs.

• Drug coverage through an employer or union

Employer or union plans are sending out letters to their enrollees explaining if their current prescription drug coverage is as good as or better than the standard Medicare prescription drug coverage.

• Prescription drug coverage through TRICARE (military retiree benefits), Department of Veterans Affairs (VA benefits), and FEHBP (Federal Employees Health Benefits Program)

Those with prescription drug coverage through TRICARE, the VA, or FEHBP are advised by Medicare to stay with it.

• People in both Medicare and Medicaid

If Medicaid currently covers a beneficiary for prescription drugs, that drug coverage is switching to Medicare on January 1. The beneficiary will be automatically enrolled in a Medicare drug plan. If the beneficiary doesn’t like the plan, he/she can change it at any time.

• People in Medicare managed care plans

The plan may simply add Medicare’s prescription coverage, or else it may bring the drug coverage it now includes up to Medicare’s new guidelines. These beneficiaries will get a notice from their plan.

• People with a Medigap policy that includes prescription drug coverage

Medigap plans are sending letters to their enrollees letting them know if their current Medigap prescription drug coverage is as good as or better (“creditable coverage”) than the standard Medicare prescription drug coverage.

• People with prescription assistance through a state pharmacy program

These Medicare beneficiaries should contact their state pharmacy program to see how it coordinates with the new Medicare Rx benefit.

For additional information about the benefit, contact a Medicare representative by calling (800) MEDICARE (633-4227). Or call Eldercare Locator (800) 677-1116 to locate local one-on-one counselors and resources.

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