Taking advantage of Medicare's new prescription-drug benefit
In his State of the Union address two years ago, President Bush declared that "health-care reform must begin with Medicare" because "Medicare is the binding commitment of a caring society." Following his lead, Congress passed a landmark Medicare reform law in 2003 and paved the way for participants in the program to enjoy a prescription drug benefit for the first time ever.
Last week the President visited Arizona to explain this new benefit, which will take full effect at the start of next year. I was honored to introduce the President at a meeting of seniors in El Mirage, and echoed his message about the importance of getting good information on the new choices available. For many of Arizona's 800,000 Medicare beneficiaries, this program could make the difference between being able to afford prescription drugs, and not.
The first thing to make clear about the Medicare prescription drug benefit is that it is voluntary - no one is required to sign up for coverage. However, there are significant benefits for those who do.
Under the program's umbrella, at least 19 organizations will offer prescription-drug plans in Arizona. The final details of those plans are still under negotiation, but a detailed list will be included in the Medicare & You 2006 handbook to be mailed to all beneficiaries in October. Monthly premiums for most people will range from $20 to $35, with an average of about $28. Enrollment opens on November 15, with significant incentives for those who sign up by May 15, 2006.
Many of the available options have deductibles lower than the $250 level in the "standard" Medicare benefit. Some have no deductibles at all. Such plans can provide help with drug costs starting with the very first dollar that a beneficiary spends. Many offer "enhanced," additional benefits - like coverage of generics - and still have monthly premiums of less than $30.
For low-income beneficiaries, there will be five organizations offering zero-premium plans. Those who qualify for Medicare's low-income subsidy will automatically be enrolled in one of these plans next Spring if they have not already chosen one of their own.
Between now and November 15, I strongly urge Medicare beneficiaries to make a list of current prescription medications and review them with your doctor. Be sure to include dosage and costs (including any discounts). Once you receive your copy of Medicare & You 2006, do some comparison shopping. Here are just a few ways to get started.
* Call 1-800-MEDICARE (1-800-633-4227)
* Research the various plans on the Internet
* Call the individual prescription-plan providers
* Ask your doctor and pharmacist
* Get free copies of the booklets Introducing Medicare's New Coverage for Prescription Drugs and Your Guide to Medicare Prescription Drug Coverage at www.medicare.gov or by calling the main Medicare telephone number listed above
* Take advantage of organizations that provide help, like the Medicare Rx Education Network (202-326-1816, or www.medicarerxeducation.org ) and the National Council on Aging, which offers a terrific free guide to the new system at www.benefitscheckup.org
* Call the Arizona State Health Insurance Assistance Program (SHIP) for free personalized health insurance counseling, at 1-602-542-6595 or 800-432-4040.
* Attend local health fairs and other events. Schedules and other information are available at www.eldercare.gov , or call an Eldercare Locator information specialist at 1-800-677-1116
The new Medicare prescription-drug benefit is a major addition to a bedrock institution upon which millions of seniors depend. As with all big changes, there will be glitches, and some things may seem confusing at first.
But rest assured: All participating plans must meet Medicare's standards for providing medically necessary drugs, as well as access to convenient pharmacies, long-term care facilities, and home infusion treatments (most will also offer the option of using mail order services).
By taking advantage of the fact that providers are competing for your business, you can choose the plan that best meets your needs.
Senator Kyl serves on the Senate Finance and Judiciary committees and chairs the Senate Republican Policy Committee.