May 9, 2006 > First Deadline to Enroll in Medicare Part D Approaching
First Deadline to Enroll in Medicare Part D Approaching
Washington Hospital Insurance Service Can Help You Choose a Prescription Drug Plan
he first enrollment period for Medicare Part D, the federal insurance program's new prescription drug benefit, ends on May 15, 2006. There are a range of options that are available to seniors, (52 different plans in California alone) so knowing how to maneuver through the program and make the best choices is not a simple task.
What are the important factors that eligible seniors need to consider when choosing the best prescription plan and how do they go about signing up? There are many things for someone to take into account -- including premiums, deductibles and payments for your drugs. Convenience is also important. Which pharmacies are close to your home and will they cover your necessary prescriptions? Fortunately, there are resources available to help answer these difficult questions.
Linda Dawal, Health Insurance Information Service Coordinator for Washington Hospital has been advising and enrolling seniors into Medicare Part D prescription drug plans since the enrollment period began last November.
"A lot of seniors have waited because they don’t understand the new program, and they are a little unsure about what their options are," Dawal says. "My job is to help people navigate through the plans and figure out what’s best for them."
Those who do not register by May 15 can still enroll but will face a penalty. Unless they already have prescription coverage plans that are equal to or better than Medicare Part D, those who register late will be hit with a one percent - per month penalty hike in monthly premiums. People that have already registered in a Medicare Part D plan can make changes during the annual enrollment periods -- November 15 to December 31, 2006.
"The penalties can add up and be very costly if an individual doesn’t sign up," adds Dawal.
How a Standard Medicare Part D Plan Works:
<LI> A person pays a monthly premium -- which can cost anywhere from $5.41 to $26 a month.
<LI> The person pays the first $250 per year for prescriptions. This is the "deductible."
After the person pays the $250 deductible, here’s how the costs work:
<LI> After the $250 deductible, the person pays a co-payment which varies depending on the plan and the specific tier of the medication.
<LI> Once the person reaches $2,250, the person must pay 100 percent of the next $3,600 in drug costs. (This is often referred to as the "donut hole.")
<LI> After the person has spent $3,600 out of their own pocket, the insurance covers 95 percent of the drug costs for the rest of the calendar year.
It’s important to note that there are other prescription plans available that do not have a deductible. Dawal says seniors need to keep a few things in mind so they don’t fall into the "donut hole" and pay more money out of their own pocket.
"The recommendation is that people choose pharmacies that save them the most money and to talk to their doctors about generic brands," Dawal adds. "The big eye opener is when people discover how the plans vary and they learn that the best plan they thought about joining ends up being the most expensive."
How do I Enroll?
Since November, Dawal has helped hundreds of people sign up for Medicare Part D coverage at her office at Washington Hospital and she has also been advising people at two local senior centers in Newark and Union City.
"We offer free one-on-one consultations so that people can look at the plans that best suit their needs and help enroll them at the same time," says Dawal. "This helps people gain a better understanding of how a specific plan will impact their pocketbooks."
You can visit the Medicare website and enroll online at www.medicare.gov for a "plan finder" that will help you sort through each specific plan. You can also enroll by calling (800) MEDICARE -- which is (800) 633-4227.
"I recommend that people use the Medicare website to enroll, says Dawal. "It’s quite easy and I use this method to help enroll people everyday."
The Washington Hospital Health Insurance Information Service is a free and confidential service that can provide you with all the information you need to make an informed decision about your health insurance. For more information, please call (800) 770-9447 anytime from 8 a.m. to 5 p.m., Monday through Friday or visit the Washington Hospital Web site at www.whhs.com, click on "For Our Community" and select "Health Insurance Information Service" from the drop-down menu.
For more information about the Medicare Part D prescription drug plan or to schedule an appointment with Linda Dawal, please call (800) 770-9447. Dawal’s office is located at 2500 Mowry Avenue, (Washington West) inside the Community Health Resource Library and her office hours are Monday through Friday from 10 a.m. to 5 p.m. Please call for an appointment.
Dawal also advises people by appointment only at the following locations:
Newark Senior Center -- Every Monday
7401 Enterprise Drive, Newark, CA 94560
Telephone: (510) 742-4845 -- Ask for Kelly
9 a.m. -- 4 p.m.
Ralph and Mary Ruggieri Senior Center -- Every Thursday
33997 Alvarado-Niles Road, Union City, CA 94587
Telephone: (510) 489-6629 -- Ask for Allison
9 a.m. -- 4 p.m.