DOBSON — Medicare Part D Prescription Drug Plan (PDP) participants, confused by the details, options and deadlines rushing at them at the end of their enrollment periods may have now discovered drugs covered last year are not covered this year.
“Many Medicare beneficiaries may have kept their PDP simply so they wouldn’t have to worry about the six-week annual election period and now they may feel stuck,” said Seniors’ Health Insurance Information Program spokesperson Carmen Long. “There is good news. If they fall into one of two categories, they may not be stuck with their plan after all.”
Long explained beneficiaries who have Medicare and Medicaid or the original Medicare and have been approved for the federal Extra Help Low Income Subsidy (LIS) program through the Social Security Administration have a continuous special election period where they can change their Medicare Part D PDP at any time.
“In some cases participants have chosen to go back to their original Medicare plan where the copay was 20 percent of the prescription drug with 80 percent being paid by Medicare,” said Long. “Some of the important things to understand about this choice are how high co-payments can be without using a supplemental policy.”
The Extra Help program assists eligible Medicare beneficiaries in paying for their prescription drugs. Participants must have an annual income at or below $16,335 for an individual or $22,065 for a married couple living together to qualify. Resources required to list do not include a primary residence or a vehicle. Burial expenses are also allowed.
“There are different levels of the Extra Help program with different criteria to meet to be eligible,” said Long. “It is also important that participants contact their physicians to see if they participate in the Medicare program.”
Persons who have not applied for the extra help program but think they are eligible may call the Senior’s Health Insurance Information Program (SHIIP) at 1-800-443-9354 or the Social Security Administration at 1-800-772-1213. Persons may apply directly online at www.socialsecurity.gov.
“The more they can save on medications the more they can spend on other things they need,” added Long. She said that a lot of people in Surry County don’t realize they qualify for the Extra Help program and other have never thought to ask because their prescriptions were inexpensive.
“Medicare is a confusing topic for most people, but SHIIP is available to help them work through their options,” added Long. She said SHIIP is a division of the North Carolina Department of Insurance which provided free and unbiased information about Medicare to beneficiaries and their caregivers. Persons with questions or concerns about Medicare options may call SHIIP at 1-800-443-9354.