Understanding the New Medicare Benefits

Article submitted by Rosemarie Hurley, CSA, Long-Term Care Specialist.
For more information, she can be reached at 239-495-6678, or visit her website: www.longtermcareins.nu.

With all of the Medicare Reform legislation, everyone seems to be in a quandary as to what it all means. Sometimes a little simple and "down to earth" explanation is what we are all seeking. While not all of the changes benefit everyone, the majority of what has been passed as law, is good.

Beginning May 3, 2004, the prescription drug discount cards were approved by Medicare. And the companies offering these cards must meet with Medicare guidelines. These companies will be negotiating with the drug companies for discounts on prescription drugs. There are many cards to choose from and to see what is available for you in your area you can go to www.Medicare.gov. For those without computer access you can call 1 800-Medicare.

Now, unless you already have a Medigap plan that includes prescription drug coverage, you can obtain one of these cards. If you have another type of discount card, you may keep it along with the Medicare discount card. The Medicare cards cost $30.00 per year and a new fee is required each year. If you change cards during the year, you will have to pay the $30.00 fee again. If you live in two states for part of the year, it would be better to buy a National Card so it will be more flexible.

For certain people who are low of low annual income, there is a monetary Medicare assistance of $600.00 per year - no more than $12,124 per year for a single and no more than $16,363 per year for a couple. Your assets do not count, only your annual income. You can apply for the $600.00 credit at the same time they apply for the prescription card. If approved, Medicare will pay the annual enrollment fee for the discount card as well. The $600.00 will be applied to the drugs you order, and deducted from the card every time you order prescriptions. If you do not use all of the $600.00 credit, you can roll it over to the following year and add it to the new $600.00 allotment. And depending on when in the year you join the program, the amount of value may be pro-rated.

Lastly, in 2006 Medicare will be adding a New Prescription Drug Benefit. It will be purchased like a small insurance plan with a cost of about $ 35.00 per month. It will have a $250.00 deductible and a 75/25 coinsurance up to $2250.00 of expenses. After the $2250.00 in expenses, the prescription drug benefit card can be used to obtain discounted prices until the beneficiary spends $600.00. More information will follow about this benefit as we get closer to having the benefit available.

After 2006, plans H-I-and J will not be sold, but for those who have them, they will be allowed to be renewed if participants DO NOT participate in the new Prescription Part D program. Two new plans will be introduced that will be more affordable and offer 50% or 70% reimbursements.

Additional new benefits are also being introduced in 2005 which will include an initial voluntary physical for first time Medicare Enrollees, a diabetic screening, and then insulin and syringes will be included in the Part D benefit in 2006 to name only a few changes.

If you choose not to contact Medicare and would like me to help you to familiarize you with the benefits, or if you need help comparing Medicare Supplements, I would be happy to hear from you.

Rosemarie Hurley, CSA is a Long-Term Care Specialist with over 12 years experience in the Senior Market. She represents all of the major LTC insurance carriers in the industry.