General Overview
In December of 2003, the Medicare Prescription Drug Improvement and Modernization Act of 2003 was signed into law. This new law makes Medicare prescription drug benefits available to Medicare beneficiaries starting in January 2006, and represents the most significant change in Medicare since the program began. Medicare beneficiaries have long been faced with the financial burden of the rising cost of outpatient prescription drugs. Currently, one fourth of seniors with Medicare alone do not have prescription drug coverage. Now, thanks to the legislation that created Medicare Part D, prescription drug benefits will become available to eligible Medicare beneficiaries starting in January 2006.
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Eligibility
Your employer may offer this program to retirees entitled to Medicare Part A and/or enrolled in Medicare Part B. Eligible individuals may only enroll in one Medicare prescription Drug Plan at a time and may not be enrolled in a Medicare Advantage Plan (HMO, PPO), unless they are a member of Medicare private-fee-for-services plan that does not offer Medicare prescription drug coverage or are enrolled in an 1876 Cost Plan. You may join a Medicare Prescription Drug Plan during certain times of the year. If you enroll in your employer’s Part D plan, you should not apply for individual Part D through another carrier.
If you have a Medicare Supplement (Medigap) policy that includes prescription drug coverage, you must contact your Medigap Issuer to let them know that you have joined a Medicare Prescription Drug Plan. If you decide to keep your current Medigap supplement policy, your Medigap Issuer will remove the prescription drug coverage portion of your policy and adjust your premium. Under certain circumstances, you can also buy a different Medigap policy without prescription drug coverage sold by your Medigap Issuer. Your Medigap Issuer cannot charge you more based on any past or present health problems. Call your Medigap Issuer for details.
Where is Blue MedicareRx Available?
The service area for this plan includes Illinois. You must live in this state to join this plan. The Medicare Program does not allow us to cover members who do not reside within our service area, unless the group meets certain federal requirements. If the group meets the requirements, we may cover members who reside outside of our standard service area. Please call Customer Service for more information.
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Financial Assistance
If you qualify for extra help with your Medicare Prescription Drug Plan costs, your premium and drug costs will be lower. When you join Blue Cross Blue Shield of ( NM, TX or RX), Medicare will tell us how much extra help you are getting. Then, we will let you know the amount you will pay. If you aren't getting any extra help, you can see if you qualify by calling:
- (800) MEDICARE (633-4227). TTY/TDD users should call (877) 486-2048, or
- your State Medicaid Office, or
- the Social Security Administration at (800) 772-1213 between 7 a.m. and 7 p.m, Monday through Friday. TTY/TDD users should call (800) 325-0778.
Beneficiaries interested in available Medicare Part D subsidies may contact Blue MedicareRx customer service at (877) 838-3875 (TTY users call (800) 693-3816) Monday through Friday, 6:00am – 6:00pm, MT.
Initial Enrollment Period and Penalties
The initial enrollment period for current Medicare beneficiaries begins November 15. Contact your employer group health plan for your specific open enrollment dates and deadlines. If you enroll in a Medicare-approved prescription drug plan after the initial enrollment period, under most circumstances, you may face a government-imposed late enrollment penalty which would result in a higher monthly premium. If you miss the enrollment deadline, under most circumstances you will have to wait until the next enrollment period and will not be able to get coverage until January 2007. Contact your employer group health plan administrator for more information.
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Last updated 12/19/2005 - S5715-MRK-NMWebsite
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