If you need Medicare Part D-rx drug info

Discussion in 'Fibromyalgia Main Forum' started by badluck, Sep 28, 2005.

  1. badluck

    badluck New Member

    My new job is answering questions about medicare part D (phone lines for most providers like BCBS, Aetna, etc will begin taking calls 10/01/05)so if anyone has questions about coverage, I may be able to help.

    The open enrollment period for anyone with part A and/or part B is November 15, 2005 to May 15, 2006. However, coverage will not actually begin until January 1, 2006 when the drug discount cards will begin to be phased out.

    You can call your provider or Medicare begining this Saturday for more information so that you have time to make your decision before enrolling.

    Please post any additional questions here and I will try to get answers for you.
    [This Message was Edited on 09/28/2005]
  2. kimj1215

    kimj1215 New Member

    Hi Badluck! What a great help you are offering everyone here. My mother is on PAAD prescription benefits. I saw a comercial that she still needed to enroll in the Medicare benefit as well. Is there something special I need to do when I enroll her?

    Thanks in advance for any info you can offer.

    Kim
  3. chp1298

    chp1298 New Member

    My hubby is on medicare as a secondary provider and I have coverage on him through my job as primary. WIll he qualify for any additional rx asisstance? The papers we recieved said you needed to be in a certain income level and we were too much so I just threw it away. If he can get help I sure want to apply.
  4. badluck

    badluck New Member

    Think of them as supplementing each other. She will still not have any permiums and at most the $5 copay, but the cost of some drugs may be even lower.

    IF your mother qualified for extra financial help in the past, she will have to apply for the assistance again, but NJ's PAAD will help you apply. If she is Specified Low-Income Medicare Beneficiary (SLMB) or Qualified Individual (QI-1) who receives PAAD benefits the enrollment for financial/extra assistance is automatic and you will NOT need to apply for the extra help. The federal Medicare program will contact you to notify you that you qualify for the extra help in this case. If you are not sure, you can call 1-800-Medicare and they will let you know if she qualifies.

    If she doesn't qualify for the extra help, she will not lose her PAAD benefits, but will still have to choose a Part D plan/provider to use those PAAD benefits.
    [This Message was Edited on 09/29/2005]
  5. badluck

    badluck New Member

    Since you husband is already on medicare, he does qualify for Part D. However, since his primary insurance is through your employment, you will need to contact your provider and have them send you a letter telling you if his RX coverage (with them) is as good as or better than what is mandated by Medicare.

    If it is better, you keep that paper and he stays on your group plan. When you retire/lose the medical coverage through your employer, that paper from your provider will enable him to get Part D with no penalties.

    If the letter from your provider states that Part D is better, he Must sign up with a Part D provider no later than 5/15/06.

    The papers you threw away because you didn't qualify were to determine if you could get extra financial assistance to pay for Part D's premiums and copayments. Even if you think you don't qualify, you should probably fill out a copy, because the review boards sometimes make special exceptions, especially if he needs a lot of medication.
  6. badluck

    badluck New Member

    is that EVERYONE!!! who is getting Medicare Part A and/or B qualifies for Part D (RX coverage). You will have to look at several plans to chose which is right for you and these will vary by providers. But EVERYONE getting Medicare is eligible for Part D. The enrollment period is November 15,2005 to May 15,2006.

    The papers you get now will only be to determine if you qualify for any FINANCIAL assistance with the premiums/copays. Even if you think you don't qualify for the asistance, you should fill out and submit the paperwork because this is a new program and there MAY be future adjustments.

    Part D is NOT dependant on your income. As long as you have MEdicare you are eligible to enroll in Part D starting 11/15/06.
  7. badluck

    badluck New Member

    questions. If there are none, I will let this go to the bottom of the list.
  8. kimj1215

    kimj1215 New Member

    Badluck:

    Thanks so much for this information. It really helped me to help Mom!

    Hugs!

    Kim