The new Medicare Part D Prescription Drug Program (PDP) is the single biggest change to Medicare since the program began 40 years ago. The new Medicare prescription drug program affects millions of individuals and many of these Medicare beneficiaries who are in North Carolina and across the country have been unsure of their choices. The Seniors’ Health Insurance Information Program (SHIIP) is a division of the Department of Insurance. SHIIP counselors help individuals sort out North Carolina’s 38 different PDPs. Cooperative Extension coordinates SHIIP in several North Carolina counties.

You can enroll in a PDP anytime during the open enrollment period, which began November 15 and lasts until May 15, 2006. If you’re unsure about which plan you want or if you need to enroll at all, you can still sign up anytime before May 15, 2006, and you’ll face no penalties.

Everyone who is enrolled in Medicare Part A or Medicare Part B has the option to join a Medicare PDP, regardless of income level and resources, preexisting conditions or current prescription expenses. Also, if you are enrolled in a Medicare Advantage Plan – such as HMO, Preferred Provider Organization (PPO) or private-fee-for-service plans – you may already be enrolled in the drug coverage plan they offer. If you do not have any other prescription drug coverage, then you may want to consider signing up for a Medicare PDP.

If you currently have prescription drug insurance coverage that is as good as or better than the Medicare PDP coverage, then you do not need to purchase a Medicare PDP. If you have creditable prescription drug coverage through an employer group plan, TRICARE, or the Veteran’s Administration you should not need a Medicare PDP, and you should have already received a letter from that agency verifying the creditability of your current coverage.

If you are eligible for the coverage and don’t already have coverage that is as good as a Medicare PDP and do not enroll by May 15, 2006, then you may have to pay a one percent penalty for each month that is past the May 15 cutoff date.

Shopping for a Medicare PDP

• What prescriptions do you currently use? Ask your pharmacist to provide you with a printed list of your prescriptions including the dosage.
• Do you already have prescription drug coverage? If you are eligible for and receive prescription drug coverage benefits through the VA, TRICARE or Federal Employees Health Benefit Plan, contact them before making any changes. If you have coverage through a current or former employer or union, you should have received a notice about how the coverage compares to Medicare Prescription Drug coverage.
• Do you want the option of ordering your prescriptions by mail? Does the Medicare PDP company you are considering offer mail-order delivery?
• Do you want to stay with your current pharmacy? Some plans may restrict what pharmacy you may use. If you want to stay with your current pharmacy, determine if you can use your pharmacy with the plan you are selecting.
• Review the premium amount for any plan you are considering. This is the monthly amount you will pay for the coverage. The monthly premium amount will vary from plan to plan.
• What is the annual deductible amount, if any? This is the yearly amount you will pay before the plan begins to pay. This amount may vary from plan to plan but may not be any more than $250, and could be less.