Part D Information

Intro

Filing for "Extra Help"

Information for Beneficiaries Who Have Current Coverage

Enrolling in a Plan

Kansas Plans

Look for this logo
Medicare Rx logo
to find Medicare Part D approved plans

Information for Beneficiaries Who Have Current Coverage

CAUTION: Beneficiaries should talk to their insurer, benefits administrator, or other plan provider before they make any changes to their prescription drug coverage. If they decide to enroll in a Medicare prescription drug plan and drop their current prescription drug coverage, they may not be able to get this coverage back. And if their prescription drug coverage is provided together with their medical coverage, they might not be able to drop just the prescription drug benefit.

Beneficiaries who are dually enrolled in Medicare and Medicaid and receive pharmaceuticals through Medicaid will now get most of their drugs through Medicare rather than Medicaid.

Beneficiaries who have "creditable coverage" under an existing prescription drug plan can elect to continue to utilize their current prescription drug coverage or switch to a new Medicare prescription drug plan. "Creditable coverage" means the beneficiary's current prescription drug coverage is, on average, at least as good as Medicare's standard prescription drug coverage. "Creditable coverage" may be drug coverage from a beneficiary or spouse's employer or union-sponsored plan, a Medigap plan, a health insurance policy, the VA, TRICARE, the Federal Employees Health Benefits Program, a PACE program, the Indian Health Service, tribe, or Urban Indian Organization, or a state's high risk pool.

If a beneficiary's coverage is creditable, one may remain with the current coverage or switch to a new plan. If coverage is creditable and a beneficiary does not have a break in coverage (more than 63 days without creditable coverage), no premium penalty will be assessed if the beneficiary decides to enroll in Medicare prescription drug coverage after May 15, 2006.

If a beneficiary's current drug coverage is not creditable, a premium penalty will be assessed for waiting to enroll in Medicare prescription drug coverage after May 15, 2006. Premium costs will go up at least 1% per month for every month that the beneficiary waits to join.