Medicare RX tips

AARP Tennessee is encouraging families and friends to talk with their loved ones during the upcoming holidays about the new Medicare Prescription Drug Program, called Medicare Rx, which will begin on January 1, 2006. Over one-third of the 912,000 Medicare beneficiaries in Tennessee do not have any drug coverage currently, and those with limited incomes and high annual prescription drug costs could greatly benefit from the new coverage. Medicare Rx coverage also offers protection against future drug costs that may become significant as people age.
Tara Shaver, AARP Tennessee’s Associate State Director of Community Outreach, said, “While we know that it takes time to understand the benefit, Medicare Rx offers real savings. Just starting the conversation with your family and friends is the first step. And there are resources available to help make the decision about enrolling in the program, if it meets your needs.”
Shaver continued, “Remember that current Medicare beneficiaries have until May 15, 2006 to enroll before a penalty begins, so there is no reason to panic. But people should start that conversation today.”
Here are some items that you should bring to the table when talking about Medicare Rx:
1)     Have a list of the prescription drugs that you currently take, including the name, dosage, and number of times you take each drug in a month.
2)     Have your Medicare card handy. Everyone who is on Medicare is eligible for Medicare Rx, regardless of income.
3)     Know the name of your pharmacy where you like to have your prescriptions filled. You want to make sure that any plan in which you enroll has your pharmacy in its network. Your pharmacist can tell you which plans s/he accepts.
4)     If you receive drug coverage from an employer, union, or other source, make sure you have a letter from them stating that you do or do not have “creditable coverage,” which means coverage that is as good as Medicare Rx. If you have not received a letter, call the number on back of your insurance card immediately. If you do have “creditable coverage,” then you do not need to enroll in Medicare’s drug plan. Always check with your plan/employer before adding additional coverage to avoid interruption or loss of benefits.
5)     Know that if your income is less than $14,355 (single) and $19,245 (couple), you may be eligible for extra financial assistance. Call the Social Security Administration, and a counselor will help complete the application with you.
Once you have these items in front of you, and you have started to look at the materials from the drug companies, you may want to contact some of the companies or Medicare for more information.
If you want to call Medicare or the companies directly, remember a few tips:
1)     To avoid long hold times, do not call during normal business hours. Try to call in the early morning or late evening. Medicare has a hotline available 24/7, and most drug company call centers have weekend hours.
2)     1-800-MEDICARE is a call center. Be specific with your requests, and speak clearly. If you need help with making a decision, ask the operator for “Help choosing a drug plan.”
3)     Have your Medicare Card in front of you as well as the list of drugs you take.
4)     If your situation is complex, you may need to speak with a Medicare counselor. Medicare counselors are also available through the State Health Insurance Assistance Programs (SHIP) in each state and territory. SHIP programs operate during traditional business hours and have few paid staff, but the staff is extremely helpful.
5)     Remember to be patient. This is a new program in Medicare.
Shaver added, “AARP encourages Medicare beneficiaries to engage their families and healthcare providers in this important decision. You are not alone, and we encourage people to reach out and ask for assistance.”