Lung Disease Support & Information
Prescription Assistance
- Frequently Asked Questions
- Who is the Medicare Access Network of NC?
- Why now?
- What kinds of outreach will the network do?
- How does my organiation get involved?
Frequently Asked Questions
.
Q. Why should I sign up for Medicare prescription drug coverage?
A. Prescription drugs are a critical part of medical treatment. As we get older, the number of drugs we need and the cost of those drugs can increase substantially. A sudden illness can result in higher drug costs that are impossible to predict. Like other forms of insurance coverage, Medicare prescription drug insurance can protect you and your family against high and unexpected costs.
In addition, you can not be turned down for Medicare prescription drug coverage. You can shop around for the best-priced Medicare drug plan in your area that meets your needs.
Q. How much will it cost?
A. Unless you qualify for extra help, you will need to pay a monthly premium, an annual deductible and co-payments that will vary according to the plan you choose and where you live. Under the standard plan, individuals will need to pay a premium of about $37 per month and a deductible. After you have paid $3,600 for your prescriptions for the year, you will only have to pay 5% of the discounted cost of each prescription.
Q. When should I join?
A. If you currently are eligible for Medicare, you can sign up with a plan between November 15, 2005, and May 15, 2006. Sign up by December 31, 2005, and your coverage begins January 1, 2006.
Q. When will my drug coverage begin?
A. Your drug coverage will begin on January 1, 2006, if you sign up by December 31, 2005. If you sign up later, your coverage will begin on the first day of the month following the month you join. For example, if you sign up with a plan on January 15, 2006, your coverage will begin on February 1, 2006.
Q. What happens if I sign up late?
A. Because of a Medicare requirement to sign up by May 15, 2006, you will save more on your monthly premiums if you sign up by this date. If you choose to wait and enroll after May 15, 2006, you will pay a monthly penalty of 1% of the monthly premium, and the penalty will continue over the life of your coverage.
Q. I am healthy and don.t use many medications, so why should I join a Medicare drug plan?
A. Even if you have low drug costs today, these costs could be higher in the future if you become ill. Just like other forms of insurance, the Medicare prescription drug coverage will protect you and your family from financial loss in the event of a serious illness. A recent study found that the average Medicare beneficiary will receive significantly more in benefits from having Medicare drug coverage over his or her lifetime than he/she will pay in premiums.
Q. Are all Medicare drug plans the same?
A. No, plans will be different. Plans will vary on the drugs they cover. They also will have different pharmacies in their networks and different premiums, deductibles and co-payments. However, all plans will provide protection from catastrophic drug costs.
Q. How often will I be able to change plans?
A. If your needs change, so can your coverage. Each year, there will be an open period in which you can review your plan choices for the coming year and either rejoin in your current Medicare drug plan or choose a new one. You may also have another opportunity during the year to switch plans under limited circumstances. For example, if you move out of the service area of your plan, you.ll have an opportunity to choose another plan that serves your new area.
Q. How does the plan protect people on Medicare against high out-of-pocket drug costs?
A. This benefit works like many insurance products in that it provides protection from catastrophic events. The Medicare prescription drug coverage recognizes the need to protect people on Medicare from high out-of-pocket drug expenses. Once an enrollee spends more than $3,600 out-of-pocket in a year for prescription medicines, Medicare and your participating drug plan will cover 95% of the costs above that level.
Q. What happens if I currently have employer-provided drug coverage?
A. Roughly a third of Medicare beneficiaries get drug coverage from their former employer. If your employer continues to offer prescription drug coverage, you can decide whether to keep your existing coverage or switch to another plan.
Note: if you elect to drop your employer-sponsored coverage, you might not be able to re-enroll in your employer-provided drug coverage.
Q. Is there special help for me if I have a limited income and resources?
A. Yes. You may qualify for reduced premium and cost sharing if you meet certain limited income and resource guidelines. For more information about this coverage call 1-800-MEDICARE (1-800-633-4227) or your local Social Security office.
Q. What should I do next?
A. Get ready to enroll in November. Make a list of the specific names and dosages of each medication you take. Look for and review the materials that you will receive in the mail and attend any informational events taking place in your community.
Q. Who do I call for more information or when I am ready to enroll?
A. For more information and enrollment help contact your state health insurance assistance program at The North Carolina Department of Insurance, Seniors. Health Insurance Information Program 919-733-0111 or 1-800-443-9354 (toll free) or online at www.ncdoi.com.
Q. How do I find more information about the Medicare Access Network of North Carolina? Click Here
WHO ARE WE?
We're one of 50 state efforts about to launch in September and we're organized nationally under the auspices of the Medicare Rx Education Network. Maybe you've seen our television ads. Here in North Carolina, we're a network of locally based healthcare, social service and professional organizations and we've come together to educate beneficiaries and their caregivers about the new Medicare prescription drug benefit.
WHY NOW?
Because the enrollment period begins on November 15th and we want everyone eligible for Medicare to know that this important new benefit is out there for them to take advantage of. Since there is real economic value to enrolling early in this benefit, we believe that now is the time to begin outreach to seniors.
WHAT KINDS OF OUTREACH WILL THE NETWORK DO?
Simply put-we believe that a collective voice from the healthcare community stressing the importance of this benefit will encourage seniors and those who care for them to participate in the benefit-and that act will improve lives and pocketbooks.
TO ACCOMPLISH THAT GOAL, THE NETWORK WILL:
- conduct earned media outreach such as editorial board meetings and reporter briefings with partner representatives and members of the media covering Medicare.
- hold signup rallies and enrollment events highlighting key dates and opportunities in the enrollment process.
- engage in train the trainer activities-ensuring that those involved in counseling seniors have all the best information.
- partner with Members of Congress as they conduct town hall meetings -encouraging their constituents to enroll.
HOW DOES MY ORGANIZATION GET INVOLVED?
Become a partner and help us spread the word. It's that simple.
The Network is not a coalition. It has no agenda other than to promote the prescription drug benefit to the general public.
This is an action oriented outreach effort-we know you're busy and the last thing you need to do is attend a meeting for the sake of a meeting so the focus will be on activities that actually reach Medicare beneficiaries.
For more information on this important effort, please contact:
Randolph E. Cloud
919-821-1004
randolph@recanc.com
