Picking A Medicare Drug Plan

Tuesday is the first day people can enroll in the new Medicare prescription drug plans. Already, many find the new plans confusing.

The good news, says AARP Director of Health Strategies Cheryl Matheis, is that there are lots of choices and there's plenty of help available.

"It's more time-consuming than confusing," Matheis The Early Show co-anchor Rene Syler. "If you are a person who wants to know every single detail about all of the plans that are possibly applicable to you, you could take a lot of time doing it. But you can also simplify it for yourself by reducing it to the things that are most important to you, and getting some help."

You have to just come to terms with the idea of selecting a plan, and not worry about whether or not you have the perfect plan, she says.

Matheis suggests you start by taking into account such factors as your monthly drug costs, the drugs you're taking, and whether you get them from pharmacies or mail order plans.

"The plans are required to cover drugs for every condition," Matheis says, "but they are not required to cover every named drug. So if you have a certain condition, like high blood pressure, there will be a drug that covers that. But it might not be the one that you're currently taking.

"Not every pharmacy, not every pharmacy network participates in all plans. So if you're a person who has a relationship with your pharmacist or works with a particular pharmacy or likes to get things by mail, then you would want to find out whether your pharmacy or whether the mail order is in your network."

Timing enters the picture as well, Matheis says.

You have six months, until May 15, 2006, to sign up, she points out. That's a very long window to sift through all the information and make a decision. If you wait until after May 15, 2006, you'll pay a penalty and a higher premium and you'll have to wait until the next open enrollment in November 2006.

"What we're encouraging people to do," Matheis tells Syler, "is take their time. But we'd like them to act before May 15. If you're interested in having coverage on Jan. 1, you really need to sign up before then. So that would give you six weeks from now, which is a good time. It's a time when families get together. You can get help from your relatives and you could make a decision. But if you're really not sure at that point, you certainly should take your time and make a decision comfortable for you."

What about cost?

"The national average is $32 a month," Matheis says. "The lowest is under $2 a month, but most of them are in the $20-$30 range. The higher cost ones will provide more benefits.

"There is additional assistance available for those with limited income. If you're single and make under $14,355 or married and make $19,245 a year, there are special programs to help you. Those people need to contact Social Security and get an application to be part of that program as well."

Matheis observes that help is as close as a computer or phone.

FOR DETAILED INFORMATION ON MEDICARE PRESCRIPTION DRUG COVERAGE, TRY THESE RESOURCES

  • Medicare or call 1-800-MEDICARE

  • WebMD Resources On Medicare Rx Benefits

  • AARP Medicare Prescription Drug Coverage resources or call 1-888-OUR AARP

  • Social Security Administration or call 800-772-1213

  • Epocrates.com Medicare Part D information

  • Centers for Medicare and Medicaid Services

  • U.S. Pharmacopia
    • Melissa McNamara

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