Senior News February, 2004 Vol. 25. No. 2

 

Published by the Humboldt Senior Resource Center in Eureka, California. HSRC is a non-profit community-based organization offering services for senior citizens, multi-generational families and caregivers.

Easter Seals addresses needs of people with early dementia

How the new Medicare changes affect you - Part II

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Ask HICAP
How the new Medicare changes affect you - Part II
by Anne Antoville

The Medicare Prescription Drug, Improvement and Modernization Act of 2003 will bring changes to the Medicare program including a prescription drug benefit. This year, Medicare-approved discount cards will be available in May (see Senior News January 2004).

2005

New preventive benefits will be available, including screening tests for heart diseases and diabetes. In 2005 the part B deductible will be increased to $110 per year; beginning in 2007 it will be indexed to inflation and will likely increase.

2006 Medicare Part D

Beginning in 2006, Medicare prescription drug benefits will be available. Enrollment in Medicare prescription benefits will be voluntary, but there will be a penalty for delaying enrollment of at least one percent per month for life, unless you already have prescription benefits through another health plan. You will not be able to get Medicare prescription benefits if you have another plan with prescription benefits.

Private companies will be able to offer Medicare drug plans. The premiums, deductible and other features may vary.

If no private plans are available, the Center for Medicare and Medicaid Services is required to offer a standard Medicare Drug plan. This will be known as Medicare part D. The premium for part D will initially be $420 per year. The plan will have a $250 deductible per year; this is in addition to the $110 part B deductible. The plan will pay 75 percent of prescription costs after the deductible has been met up to $2,250. Medicare will use its own formularies to decide which drugs may be covered by the plan.

Once your prescription costs reach $2,250 the plan pays nothing until your prescription costs reach $5,100. This is called the doughnut hole. The doughnut hole costs cannot be covered by a Medigap plan or any third-party plan. After your prescription costs exceed $5,100, Medicare part D will pay 95 percent of the costs.

There will be some assistance for people with low incomes which will be addressed in a following article.

If you have questions or problems with Medicare or health insurance, HICAP provides free information and individual counseling. Call 443-9747 in Humboldt and 464-5500 in Del Norte.

Anne Antoville is HICAP program manager. HICAP is the Health Insurance Counseling and Advocacy Program of the Area Agency on Aging. Anne will answer your questions at a special presentation about the new Medicare bill at the Humboldt Senior Resource Center, 1:30 p.m. Feb. 12.