Q&A: Medicare drug benefit
By Times staff writers
Published August 24, 2005 ST. PETE TIMES

How will the new Medicare drug benefit work?

Beginning Jan. 1, people on traditional Medicare can sign up with a private discounter to get prescription drugs at a reduced rate. After a $250 deductible, Medicare will cover 75 percent of the next $2,000 worth of drugs. The beneficiary will pay 100 percent of total costs between $2,250 and $5,100 in one year. Medicare will then pay 95 percent for any costs above $5,100. People in Medicare HMOs will receive coverage through those plans.

What will it cost?

To qualify, you must pay a new Part D premium of about $32 a month, the $250 annual deductible, plus coinsurance. HMOs and some of the private discount plans may waive some of these out-of-pocket costs. Plus, low-income people may receive subsidies.

What happens next?

The signup period begins Nov. 15. A month before that, Medicare will send out information on which drugs private insurance plans will cover and costs. The media and Medicare HMOs will step up publicity in October to help consumers choose. Government and advocacy groups will provide advisers as well.
Is this a good deal for me?
October's information blitz will help answer that question. Even advocates who criticized the program say most people should sign up. Like all insurance, it grows more costly if you don't sign up right away.

Who qualifies for help with out-of-pocket costs?

Beginning in 2006, people on Medicaid will get their drugs through Medicare. Other low-income people must apply for special assistance. This includes single people with incomes below $14,355 and married couples with incomes below $19,245 - as long as their savings, stocks and bonds do not exceed thresholds. The Social Security Administration will mail out application forms to anyone who asks; authorities recommend you fill out and return the forms immediately.

Where can I get more information?

For application forms for low-income assistance, call the Social Security Administration at 1-800-772-1213 or visit www.socialsecurity.gov For general information on the drug plan, call 1-800-633-4227 or visit www.medicare.gov Florida's SHINE program at 1-800-963-5337 provides volunteers who can answer questions and help with paperwork.