See Full List of Important Dates How New Drug Coverage Works Help for Those on Limited Incomes

The Medicare health insurance program for older and disabled Americans will start covering prescription drug costs on January 1, 2006. It's called Medicare Part D—or Medicare Rx—and anyone who wants this coverage must take action to choose one of the plans available in their area.

Below are links to new tools offered at www.Medicare.gov to help you find the right drug plan. After that is a summary of how Medicare Part D will work.

The Centers for Medicare & Medicaid Services (CMS) has created new tools to help you:

• Learn about the new Medicare prescription drug coverage;
• Find and compare prescription drug plans that meet your personal needs; and
• Enroll in the prescription drug plan that you select.

Start learning about prescription drug plans, how to compare them, and how to apply for the extra help, with A Guide to Getting Started on the Medicare Web site.

Other resources include:

A Landscape of Local Plans – an online tool to help you view all of the plans and their specific information by area.

The Formulary Drug Finder – a tool to help you find plans in your area that cover the drugs that you need.

If you are a cancer patient, you should look at the plans that are offered in your state that cover the drugs that you need, as well as compare your current monthly premiums, deductible amounts and copays for your medications with those amounts required under the new plans.

More information about the Medicare’s Rx Drug Benefit is listed further down this page, at the Medicare Web site, and by calling the agency at 1-800-MEDICARE (1-800-633-4227).

Medicare will offer insurance coverage for prescription drugs through a handful of different Medicare drug plans. Private companies will work with Medicare to offer these plans. Anyone with Medicare Part A and/or Part B can join a Medicare drug plan offered in their area. To get this prescription drug coverage, however, you must take action. You must choose a drug plan meets your needs and you must officially enroll.

The second category will include Medicare prescription plans that add coverage for medicine to your original Medicare plan, as well as some Medicare cost plans and Medicare private fee-for-service plans.

Standard Coverage. All plans must provide at least the following minimum coverage for prescription drug costs:

If you join in 2006, for covered drugs you will pay:

• A monthly premium (varies depending on the plan you choose, but estimated at about $32.20 in 2006).
• The first $250 per year for your prescriptions. This is called your “deductible.”

After you pay the $250 yearly deductible, here’s how the costs work:

• You pay 25% of your yearly drug costs from $250 to $2,250, and your plan pays the other 75% of these costs, then
• You pay 100% of your next $2,850 in drug costs (Note: not all plans have this “hole” in coverage), then
• You pay 5% of your drug costs (or a small copayment) for the rest of the calendar year after you have spent $3,600 out-of-pocket. Your plan pays the rest.

If you have limited income and resources, you may qualify for extra help paying your prescription drug costs. If you qualify, you will get help paying for your drug plan’s monthly premium, yearly deductible, and prescription copayments.

The amount of extra help you qualify for will depend on your income and resources. People with the lowest incomes pay no premiums or deductibles and small or no copayments. You may qualify if your income is less than $14,355 ($19,245 for a married couple living together), and your resources are less than $11,500 ($23,000 for a married couple living together). The amounts listed are for 2005. If you live in Alaska or Hawaii, or pay more than half of the living expenses of dependent family members, income limits are higher.

Some people will automatically qualify, others may apply and qualify. Medicare mailed letters to people who automatically qualify for extra help in May or June. If you didn’t automatically qualify, the Social Security Administration (SSA) sent people with certain incomes an application for this extra help. If you got this application, fill it out and send it back to SSA as soon as possible. If you didn’t get an application but think you may qualify, call 1-800-772-1213, visit www.socialsecurity.gov on the web, or apply at your State Medical Assistance office.

The territories have their own rules for providing extra help to their residents. To find out more about their rules, call your State Medical Assistance office, visit www.medicare.gov on the web or call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.

• Now: Check out the new tools available on the Medicare Web site (www.Medicare.gov) to find a plan that matches your needs. Or you may call 1-800-MEDICARE for the phone number of your State Health Insurance Assistance Program (SHIP) and get personal help with your choice.
• October / November 2005: Watch your mail for the “Medicare & You 2006” handbook that will include information about Medicare drug plans available in your area.
• November 15, 2005-May 15, 2006:You can join a Medicare drug plan to help lower your drug costs. To avoid paying a penalty, most people need to enroll by May 15, 2006.
• December 31, 2005: This is the last day that state Medicaid programs will pay for prescription drugs for people with both Medicare and full Medicaid coverage. If you have Medicare and full Medicaid coverage and have not joined a Medicare drug plan by this date, Medicare will automatically enroll you in a plan so you don’t miss a day of prescription drug coverage.
• January 1, 2006: Medicare prescription drug coverage begins if you enroll by December 31, 2005. If you enroll in a drug plan after December 31, 2005, your coverage begins on the first of the month after you enroll.
• May 15, 2006: The last day to join a plan without paying a penalty.

• Read your “Medicare & You 2006” handbook for the drug plans available in your area.
• Visit www.Medicare.gov on the web and click on the various tools available under Medicare Spotlights OR select Search Tools at the top of the page. Call 1-800-MEDICARE (1-800-633-4227). TTY users call 1-877-486-2048.
• You can get free personalized counseling from your State Health Insurance Assistance Program (SHIP), and other local and community-based organizations. Call 1-800-MEDICARE to get the telephone number of the SHIP nearest you.
• Visit http://www.medicarerxeducation.org/ on the web. ACS has joined with other organizations through the Medicare Rx Education Network to reach out to people with Medicare.

The Medicare Prescription Drug, Improvement and Modernization Act of 2003, also known as the Medicare Modernization tct, was passed by Congress and signed by the President on December 8, 2003. The intent of this legislation is to provide Medicare beneficiaries with prescription drug coverage, known as Medicare Part D.