“It's been forty years since the original Medicare program began. Now
comes prescription drug coverage,” Pam Matthews said. As Social
Security Public Affairs Specialist from the Fairhope office, she was
well prepared for the September meeting of Zion's breakfast and speaker
program called “Men's 710.” “Medicare Part D is the first permanent
addition to Medicare and will take effect January 2006,” Matthews
continued as she reviewed basic Medicare eligibility criteria for
seniors, for SSI, for folks with renal disease, and those with Lou
Gerig's Disease.
Come this November 15, 2005 eligible seniors and others
may sign up for coverage to start January 1, 2006. New Medicare Handbooks
will be received by seniors in the first week of October and each
material packet will lay out between 2 and 6 plans for drug coverage,
each program customized for the individual state. Basic coverage per
person will be $37 per month with a deductible of $250 per year and
copay of 25% up to the first $2250 spent. There is something called
the "gap" for those dollars spent above $2250 and less than $5100, but
above that $5100, 95% of drug costs will be covered, a senior paying
the other 5%. The typical senior will save about $1000 a year, but if
costs are catastrophic, the amount saved will be much higher. The
first sign-up period will be November 15 to May 15, but beginning in
2006 subsequent enrollment periods will be November 15 to December 31.
Seniors are receiving a variety of solicitations from various providers
or middle men seeking to sign people up for “special plans” and
“special programs” which are essentially “add-ons.” The State Health
Insurance Program (SHIP) at 1-800-243-5463 is a resource that any
senior may call and get the facts on any program being offered. “Scam
protection” information is available from Deloris White in Mobile at
251-433-6541 as well. Seniors may talk to a real person at Medicare
about prescription drug issues by calling 1-800-633-4227 and hitting
“0” after connection. And don't forget that resource that all seniors
should know, the Council on Aging at 251-972-8506.
There are other prescription drug programs that are not part of
Medicare. The QMB program (Qualified Medicare Beneficiary) is a state
program administered through Alabama's Medicaid Office, as is the SLMB
program (Specified Low Income Medicare Beneficiary). Information
concerning these programs is available at 1-251-472-4360.
Pam Matthews was a veritable treasure trove of information about the
new Medicare part D plan, its alternatives, and who is eligible to be
on the plans at little or no cost. Any senior may also access current
drug benefit information at the Medicare website.
