Medicare Prescription Drug Coverage - NEW

Information on the Medicare Prescription Drug Coverage http://www.medicare.gov/medicarereform/drugbenefit.asp

ON THIS WEB PAGE YOU WILL FIND THE FOLLOWING SUB SECTIONS
Medicare Prescription Drug Plan Cost Estimator
This tool provides beneficiaries with an example of potential savings they can anticipate with Medicare Prescription Drug coverage. The cost estimator assumes that you have no current drug coverage or receive any type of discounts, such as from a drug discount card, on your prescription drug cost. If you know what you spend monthly on prescription drugs you can use the cost estimator to see what your potential savings will be by joining a Medicare prescription drug plan. It will also provide you with information on the lowest premium available in your State. The cost estimator is a quick tool to give you a sense of the savings you can anticipate with Medicare Prescription Drug coverage. This tool is not able to take into account any insurance you may have now for drugs. Therefore, if you currently have insurance for drugs, the tool will not be able to compare current costs to those you may have in the future if you switch to Medicare drug coverage. It also has two articles in PDF format, one entitled
"Getting Started" and the other "Things to Think About When You Compare Plans."

Your Medicare Prescription Drug Coverage Options Starting January 1, 2006, Medicare will offer insurance coverage for prescription drugs through Medicare prescriptions drug plans and other health plan options. Medicare's new prescription drug coverage will typically pay over half of your drug costs next year, for a monthly premium. It will also provide peace of mind because it protects you once your out-of-pocket drug spending is more than $3600 in a year. Even if you don't use a lot of prescription drugs now, you should consider joining. Your next steps depend on the type of coverage you have now. Please answer the questions below for information to help you understand what you need to do next. Important points you need to know:
· Medicare prescription drug coverage helps you pay for the prescriptions you need.
· Medicare prescription drug coverage is available to all people with Medicare.
· There is additional help for those who need it most.
· Medicare prescription drug coverage pays for brand name as well as generic drugs It then has a tool to help you decide if this program will be of benefit to you. Some people on Medicare already have other prescription plans that may be better than this new plan.

Extra Help for People with Limited Income and Resources
This is one that many of you will no doubt be able to take advantage of or are already taking advantage of. Apply Online for Extra Help with Medicare Prescription Drug Plan Costs If your resources are less than $11,500 (single) or $23,000 (married) you may qualify for extra help paying for Medicare Prescription Drug Coverage. If you haven't received an application or information about the extra help, and you think you may be eligible, you should apply. Remember, as Department of Health and Human Services Secretary Leavitt says, "If in doubt, fill it out!" You can apply Online by visiting the Help With Medicare Prescription Drug Plan Costs section on the Social Security Administration website. Some of you who have been getting this extra help may have already received notification that your new prescription drug plan premiums will be paid for you. This will be a huge help.

Frequently Asked Questions
All types of Questions and Answers concerning this program, such as:
QUESTION - How do I join a Medicare Prescription Drug Plan?
ANSWER - You can join a Medicare Prescription Drug Plan in the following ways:
*By paper application. Contact the company offering the drug plan you choose and ask for an application. Once you fill out the form, mail or fax it back to the company.
*On the plan's website. Visit the drug plan company's website. You may be able to join online. *On this website. You will also be able to join a drug plan at www.medicare.gov by using Medicare's online enrollment center.
*By calling 1-800-MEDICARE. You can join a drug plan by calling 1-800-MEDICARE (1-800-633-4227) and talking to a Medicare customer service representative.
*TTY users should call 1-877-486-2048.

QUESTION - Are any drug categories not included in Medicare prescription drug coverage?
ANSWER - Yes. Certain drugs are excluded, which means they can't be provided as part of standard Medicare prescription drug coverage. Some examples of excluded drugs include:
*benzodiazepines
*barbiturates
*drugs for weight loss or gain
*drugs for relief of colds.
However, except for non-prescription over-the-counter drugs, a plan can choose to cover excluded drugs if the plan offers more than standard coverage. Non-prescription drugs can't be included. However, under certain circumstances, they may be provided at no cost. (some examples of Benzodiazepines are Xanax, Klonopin, Diazepam) Another answer gave this information concerning what to do if your medication wasn't covered by the Prescription plan.
ANSWER - Medicare drug plans don't have to cover every drug that's included in Medicare prescription drug coverage. They only have to cover every type of drug. You should review what drugs are covered by the Medicare drug plans available in your area and try to join one that covers the same prescriptions you take now. If the plan doesn't cover your exact prescriptions, it's required to have a transition period where your current drugs may be covered for a certain length of time while you work with your doctor to find an alternative prescription drug to take that is covered by the plan. If your doctor believes you need to take your current prescription drug and should not switch to a covered prescription drug, you or your doctor can contact your plan and ask it to give you an "exception" which means the plan agrees to pay for your current drug. If the plan refuses to give you an exception, you can appeal the plan's decision. However, if you are currently stabilized on certain specific prescription drugs (like drugs for depression, cancer or HIV/AIDS), you don't have to switch to a different prescription drug. Please talk to your doctor or pharmacist to see if your prescription drugs qualify. When you join, the Medicare drug plan will send you information about its appeal procedures. Read the information carefully and call your plan if you have any questions. There are tons of Questions and Answers and if you don't see an answer to a question you have you can email them or call them. http://www.medicare.gov/ContactUs.asp
Here is a list of quick Fact Sheets that are available that can further assist you from the Centers for Medicare and Medicaid Services Website, an amazing website; http://www.cms.hhs.gov/medicarereform/factsheets.asp
Quick Facts about Your Current Prescription Drug Coverage and Medicare's New Coverage for Prescription Drugs
New Medicare Prescription Drug Coverage.
Who Can Help Me Apply and Enroll?
Quick Facts About Medicare Prescription Drug Coverage and Protecting Your Personal Information
New Medicare Prescription Drug Coverage: A Message for People Who Care for Someone with Medicare Quick Facts about Medicare's New Coverage for Prescription Drugs Tip Sheets

What Medicare Prescription Drug Coverage Means for You
Comparing Medicare Prescription Drug Coverage
Medicare Prescription Drug Coverage:
How to Join Information Partners Can Use on:
THE FIVE MAIN GROUPS BASED ON THE COVERAGE PEOPLE HAVE NOW
Information Partners Can Use on:
*People With Medicare and HIV/AIDS Other Publication
*Introducing Medicare's Prescription Drug Coverage (American Indians and Alaska Natives Version)
Medicare Prescription Drug Coverage is Available for American Indians and Alaska Natives *Prescription Drug Coverage is Available for all People in Medicare (Brochure) Introducing *Medicare Prescription Drug Coverage What Medicare Prescription Drug Coverage Means to You: A *Guide to Getting Started Vignettes/Bios/Case Studies
Basic Questions and Answers about Medicare Prescription Drug Coverage
Group 1 Basic Questions and Answers about Medicare Prescription Drug Coverage
Group 2 Prescription Drug Coverage Basics

Introducing Medicare's New Coverage for Prescription Drugs
Here are some websites if you need additional help. http://www.medicare.gov/medicarereform/drugbenefit.asp - All the Info on the New Plan http://www.medicare.gov/Subscription/default.asp Medicare Emailing List http://my.medicare.gov/ Main Medicare Portal http://www.medicare.gov/spotlights.asp#medicare2006 Medicare and You, 2006! http://www.medicare.gov/Health/flu.asp Information about Getting Your Flu Shot! http://www.cms.hhs.gov/partnerships/tools/materials/caregiversresources/default.asp

Care-giver Publications or call 1-800-MEDICARE (1-800-633-4227)

BEWARE OF FRAUD AND UNETHICAL PRACTICES!
Quick Facts About Medicare Prescription Drug Coverage and Protecting Your Personal Information

Protect Yourself from Identity Theft and Fraud
Identity theft is a serious crime that happens when someone uses your personal information without your consent to commit fraud or other crimes.
Your personal information can include your name:
*Social Security
*Medicare
*bank account
*credit card numbers
Medicare is working hard to protect you from identity theft. To help protect yourself when dealing with plans and others about Medicare prescription drug coverage:
-Keep all personal information, such as your Medicare number, safe.
-Protect your Medicare number as you would your credit card information.
-Don't give out your personal information until you are sure that a person is working with Medicare and their product is approved by Medicare.
-Know the rules about when someone can ask for your personal information.

Here are some rules from Medicare to help protect you
Medicare Prescription Drug Plans:
- can't begin marketing their products until October 1, 2005.
- can't begin enrolling people with Medicare until November 15, 2005.
- will have this "Medicare-Approved" seal on their materials. People who are really working with Medicare
- can't come to your home uninvited to sell or endorse any Medicare-related product, but they
- can call you about their plan.
- can't enroll you into a drug plan over the telephone unless you call them, or unless you are adding prescription drug coverage to a Medicare Advantage Plan or other Medicare Health Plan you already have.
Note: State Health Insurance Assistance Programs and other local organizations may help you enroll over the telephone.
- can't ask for payment over the telephone or web. The plan must send you a bill if you enroll over the telephone or web.

CENTERS FOR MEDICARE & MEDICAID SERVICES
Publication No. CMS-11065
December 2004
Remember, Medicare doesn't recommend one product over another. Call 1-800-MEDICARE (1-800-633-4227) if you aren't sure about Medicare's rules or if any of these rules appear to be broken. Don't respond to anyone or any material that breaks Medicare rules. Know who you can trust. Most people are honest and want to help you make health care decisions that are best for you. Only give out your personal information to someone you trust or to a doctor or supplier approved by Medicare. Also, make sure that you are present when your personal information is used. You can trust and get help from:
. family and trusted friends
. senior centers and other local organizations working with Medicare
. State Health Insurance Assistance Programs (call 1-800-MEDICARE (1-800-633-4227) or visit www.medicare.gov on the web to get the telephone number)
. 1-800 MEDICARE (1-800-633-4227) (TTY users should call 1-877-486-2048)or
. www.medicare.gov on the web. If you think someone is misusing your personal information, call . 1-800-MEDICARE (1-800-633-4227) (TTY users should call 1-877-486-2048), or
. the Fraud Hotline of the HHS Office of the Inspector General at 1-800-447-8477, or
. the Federal Trade Commission's, ID Theft hotline at 1-877-438-4338 to make a report (TTY users should call 1-866-653-4261).
Note: If you filled out an application for extra help and there is missing information, someone from SSA may contact you to ask for the missing information. They will only ask you for the information that's missing from the application. If you feel like you are in danger for any reason, call your local police department immediately.

If you lose your Medicare card or it's stolen, or if you need a new Social Security card, go to www.socialsecurity.gov on the web or call the Social Security Administration at 1-800-325-0778. TTY users should call 1-800-325-0778.

If you get benefits from the Railroad Retirement Board, call your local RRB office or 1-800-808-0772 or visit www.rrb.gov/default.asp on the web. For more information, about how to protect yourself from identity theft, look at www.consumer.gov/idtheft on the web. CMS Pub. No. 11147 September 2005

Any Medicare beneficiary who suspects fraud should call 1-800-MEDICARE (1-800-633-4227), local State Health Insurance Assistance Program (SHIP) or a local law enforcement agency. Medicare beneficiaries also need to be aware of how to protect themselves against identity theft. CMS has released "Quick Facts About Medicare Prescription Drug Coverage and Protecting Your Personal Information," to help beneficiaries learn some of the key ways they can protect themselves. Fact sheet can be found at : http://www.medicare.gov/Publications/Pubs/pdf/11147.pdf

Anyone with Medicare who finds that someone is inappropriately using their personal information should contact: 1-800-MEDICARE and The Federal Trade Commission's, ID Theft hotline at 1-877-438-4338 to make a report (TTY users should call 1-866-653-4261). Beneficiaries who feel in danger for any reason should call their local police department immediately. For more information about ID theft protection, visit www.consumer.gov/idtheft.

ERROR IN THE "2006 MEDICARE & YOU HANDBOOK"
Where Does the Error Occur?
This notice affects the printed area-specific versions of the "Medicare & You 2006" handbooks, which were mailed in October to people with Medicare. The error occurs in the comparison charts listing the Medicare Prescription Drug Plans, beginning with page 97-A.
Note: The electronic versions of the handbook that will be posted on www.medicare.gov by October 7, 2005 are accurate.

What is the Error?
The last column of the charts is headed "If I Qualify for Extra Help, will My Full Premium be Covered?" For each plan listed, this column should show "Yes" if the plan's premium is at or below the regional benchmark, and a beneficiary who qualifies for the low-income subsidy would pay no premium for this plan. The column should show "No" if the plan's premium is above the regional benchmark and a beneficiary who qualifies for the low-income subsidy would pay some cost toward the premium for this plan. Due to an error, this column lists "Yes" for every plan.

What is the Scope of the Error?
Approximately 60% of the Prescription Drug Plans listed in the handbook should have a "No" in this column. This error does not impact the charts listing Medicare Advantage plans.

Does this Affect Auto-Enrollment? No. People with Medicare who qualify for the low-income subsidy will still be auto-enrolled ONLY into plans where they will incur no premium. The information in the printed handbook would be used only by people who qualify for the subsidy and are considering changing to a plan other than their auto-enrolled plan.

How Can a Person with Medicare Get the Correct Information?
The handbook is just one piece of a very large effort to educate people with Medicare about the new Prescription Drug Coverage. Individuals who qualify for the low-income subsidy and use the Medicare Prescription Drug Plan Finder on www.medicare.gov will be able to see the exact dollar amount of the premium they will pay for any plan. People with Medicare who call 1-800-MEDICARE for assistance will be accessing correct premium information to make accurate comparisons and decisions. Beneficiaries will have many opportunities for personalized counseling in the local community, including outreach targeted to people who qualify for the low-income subsidy. In addition, each organization offering Medicare Prescription Drug Plans will be aware of this issue. Plans must provide correct premium information to individuals who qualify for the low-income subsidy, prior to enrollment. Medicare also has corrected the information in the affected column in the handbooks before posting electronic copies at www.medicare.gov on the web. Copies that will be posted on the web by October 7, 2005 are accurate. In addition, CMS has provided information about the error to all of our outreach and education partners and we have equipped them with information to assist people who ask about plans available to people who qualify for extra help.

We hope you find this information helpful. Please feel free to pass this information along to your groups and anyone who might qualify for the new Prescription Program.
Please contact www.medicare.gov if you have any questions concerning this program.