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General Part D InformationImportant information about Medicare Prescription Drug Plans General Overview General Overview 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 are now available to eligible Medicare beneficiaries. To view an educational brochure on Medicare prescription drug coverage, please click here (PDF File 106KB). If you have additional questions, or if you’d like to learn more, you can call Medicare at 1-800-MEDICARE (1-800-633-4227) 24 hours a day, 7 days a week. TTY users should call 1-877-486-2048. You can also visit www.medicare.gov* for the latest news on this program. Eligibility If you are enrolled in a Medicare Advantage (MA) Plan, you may not enroll in any Medicare-approved prescription drug plan unless you have a Private fee-for-service (PFFS) MA Plan that does not provide Medicare prescription drug coverage, or a Medical Savings Account (MSA). If you are enrolled in a Medicare Advantage HMO, PPO or POS Plan, you may only receive your Medicare prescription drug benefits through your MA Plan. If you are enrolled in a Medicare Advantage HMO, PPO or POS Plan, or a Medicare Advantage Prescription Drug Plan, and then enroll in an independent Medicare-approved prescription drug plan, you will be disenrolled from your Medicare Advantage Plan. You may only be enrolled in one Medicare prescription drug plan at a time. Financial Assistance Low Income Subsidy Premium Disclaimer Initial Enrollment Periods and Penalties The initial enrollment period for prescription drug coverage is the period during which an individual is first eligible to enroll in a Prescription Drug Plan. February 2006: An individual who becomes eligible for prescription drug coverage in February 2006 has an initial enrollment period from November 15, 2005, through May 31, 2006. After March 2006: An individual who becomes eligible for prescription drug coverage after March 2006 has an initial enrollment period that begins 3 months before the month the individual becomes eligible for Medicare Part A and ends 3 months after the first month of eligibility. If you join a Prescription Drug Plan after January 1, 2006, your coverage will be effective on the first day of the month after the month in which you join. For example, if you join on April 10th, your effective coverage date will be May 1st. Join prior to May 15, 2006 to avoid penalty. If you join after May 15, 2006 - you may pay a penalty. This penalty, dictated by Medicare, increases the premium by 1% for every month you do not join (unless you have coverage that is at least as good as the standard Medicare Prescription Drug Plan). You will have to pay a late enrollment penalty in addition to your monthly plan premium if you do not enroll in a Medicare Prescription Drug Plan during your initial enrollment period and you do not have creditable coverage for a continuous period of at least 63 days after your initial enrollment period. Creditable prescription drug coverage is coverage that is at least as good as the standard Medicare prescription drug coverage. You pay this late enrollment penalty for as long as you have Medicare prescription drug coverage. The amount of the late enrollment penalty will increase every year. This applies to low-income subsidy eligible beneficiaries as well. * By clicking this link, you will be leaving the Part-D Plan-specific Web pages. Last updated 06/06/2006 - S5715-MRK-NMWebsite |
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