Don't have a Medicare D plan? That program will be open for new enrollees on November 15.
How do you know if you need to pay attention to these dates?
If you answer “Yes” to any one of these questions, you should call your local Council on Aging or the SHINE program to determine whether you need to investigate Prescription Advantage:
Are you a Medicare beneficiary who has NOT signed up for Part D?
Are you a Medicare beneficiary with a Part D plan who has been charged co pays that are more than $12 for a generic drug or $30 for a brand name drug?
Are you a Part D enrollee who has hit the “doughnut hole” (otherwise known as the coverage gap) and are paying full price for your drugs at this time?
Are you a Part D enrollee who has spent close to $750 this year in out-of-pocket expenses?
Why would you want to join Prescription Advantage in addition to having your Medicare D plan? It is a supplemental plan, which is offered at little or no cost to assist you with the “gaps” in the Medicare D program, much like your Medigap policy assists you with uncovered expenses in Medicare A or B. So you may want to give us a call if:
You
You don't want to pay a deductible at the beginning of the year.
You want to limit your co pays to $12 for a generic drug and $30 for a brand name drug.
You want some level of protection during the coverage gap (this coverage varies depending on the member's household income.)
You have a single income between $29,400 and $49,000 or a joint income between $39,601 and $66,000 and you know you take enough drugs that you will pay more than $2,870 out of pocket during calendar year 2007. (These individuals are the only members paying an annual premium to Prescription Advantage. For all others, membership is free to Massachusetts Medicare beneficiaries 65 and older.)
If you are over 65 and do not belong to Medicare or MassHealth, you will want to look into a PA membership. Depending on your income, there may be a monthly fee, but it will probably be to your advantage to investigate the program.
Most of us need to hear information many times before it makes sense so keep watching the “Berkshire Senior” for prescription coverage updates and stay in contact with your local Council on Aging. SHINE will be making presentations in the community this fall on all aspects of these programs. We urge you to attend one near you if you prescription drug coverage in the 21st century! Call us at 499-0524 or 800-544-5242 to determine whether you need personal assistance with your choices, or to receive a Prescription Advantage Application.
Story contributed by Elder Services of Berkshire County, Inc.
Font Resize
