Medicare

Medicare Part D Frequently Asked Questions

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[item title=”1. What is creditable coverage and how does it affect me?”]Creditable coverage means that your prescription drug coverage with the Board of Regents of the University System of Georgia is, on average, at least as good as that which you would receive with a Medicare Part D prescription drug plan.[/item]

[item title=”2. Why should I stay with the Board of Regents prescription drug plan rather than joining a Medicare Part D plan?”]The plan that you now have with the Board of Regents is considered, on average, to be at least as good as a plan offered by Medicare Part D. In addition, you do not have to do anything to continue receiving the prescription medications that are covered by your current Board of Regents plan. Because you are currently enrolled in a Board of Regents healthcare plan, there is no pharmacy benefit coverage enrollment process. You will not have to deal with a new network of pharmacies. There are no new procedures to learn. All that you have to do is keep using the coverage that you currently have with the Board of Regents.[/item]

[item title=”3. What do I need to do to get creditable coverage?”]You do not need to do anything. You already have creditable coverage with the Board of Regents, so all that you need to do is continue using your prescription drug plan as you do now. Please be sure that you keep your October 1, 2005 notice of creditable coverage in a safe place.[/item]

[item title=”4. Why should I keep my notice of creditable coverage?”]If you decide to enroll in a Medicare Part D prescription drug plan at some later date, that notice will let the Medicare Part D plan know that you are not required to pay a late enrollment penalty which could result in a higher premium.

If you have lost your notice of creditable coverage, please call your campus Human Resources department.[/item]

[item title=”5. Because my plan with the Board of Regents provides creditable coverage, does that mean that it is a part of Medicare?”]No. The plan that you have with the Board of Regents provides pharmacy coverage that is, on average, at least as good as the coverage that is provided by a Medicare Part D plan; but the Board of Regents plan is not a part of Medicare.[/item]

[item title=”6. How does Medicare Part D work and how does it affect my coverage now?”]Medicare Part D is a federal government-funded prescription drug plan. Medicare Part D works like any prescription drug plan: you pay a monthly premium and a portion of your prescription drug costs.

If you are satisfied with your prescription drug coverage through the Board of Regents, Medicare Part D does not affect you or your drug coverage. All you have to do is stay with your current drug plan and continue to use the coverage that you have through the Board of Regents.

However, if you consider enrolling in one of the many Medicare Part D plans that will be available, you should do so between November 15, 2005 and May 15, 2006. If you enroll in one of the Medicare Part D plans before December 15, 2005 , your coverage will begin on January 1, 2006 . If you enroll in a Medicare Part D plan between December 15, 2005 and May 15, 2006, your coverage will begin the month after you enroll.[/item]

[item title=”7. I want to be sure that I am completely covered. Can I keep my coverage with the Board of Regents and join a Part D plan?”]For Plan Year 2006, the answer is “No”. There is no coordination of benefits between the Board of Regents pharmacy plan and any other plan. If you choose to enroll in a Part D plan, your prescription drug coverage provided by the Board of Regents will not supplement your Medicare Part D prescription drug coverage.[/item]

[item title=”8. I already get some prescription drugs through Medicare Part A and/or Medicare Part B. Do I still qualify for Medicare Part D?”]Yes, you still qualify for Medicare Part D, even if you already have Medicare Part A and/or Medicare Part B. Medicare Part A is hospital insurance while Medicare Part B is medical insurance for healthcare costs such as doctor’s services and outpatient care. Although you may get some prescription drugs while you are in a hospital or at your doctor’s office, only Medicare Part D provides prescription drug coverage.

Please remember: Your coverage with the Board of Regents is, on average, at least as good as that which you would receive with a Medicare Part D prescription drug plan. All that you need to do is stay with your coverage provided by the Board of Regents.[/item]

[item title=”9. What if I drop my healthcare plan coverage with the Board of Regents, but I do not enroll in a Medicare Part D plan?”]If you drop your healthcare plan coverage with the Board of Regents, you will not be permitted to obtain healthcare coverage with the Board of Regents at any time in the future. If you drop your healthcare coverage with the Board of Regents and you do not enroll in a Medicare Part D prescription drug plan, you will have to pay the full cost of your prescription drugs.

If you elect to utilize a Medicare Part D prescription drug plan, you must initially enroll in such a plan between November 15, 2005 and May 15, 2006. You may have to pay more for accessing a Medicare Part D prescription drug plan if you elect to enroll in such a plan after May 15, 2006 . Beginning May 16, 2006 , if you go for 63 days or longer without some form of Medicare Part D prescription drug coverage, your monthly premium under a Medicare plan will increase at least 1% for each month that you did not have coverage. This increased participant cost will be effective as long as you have Medicare prescription drug coverage.

Following the initial Medicare Part D election period from November 15, 2005 , through May 15, 2006 , there will be a Medicare Part D Annual Coordinated Election Period beginning on November 15 and ending on December 31 of each calendar year.[item]

[item title=”10. Can I join a Medicare Part D plan later if I want to?”]Yes. Starting January 1, 2006 , you will be able to enroll in a Medicare Part D prescription drug plan every year from November 15 through December 31. However, if you decide that you wish to enroll in a Medicare Part D prescription drug plan after December 31, please ensure that you remain covered under the Board of Regents prescription drug plan until your Medicare Part D coverage becomes effective.

If you decide to enroll in a Medicare Part D prescription drug plan without having creditable coverage with another plan, like the coverage that you now have with the Board of Regents, you may have to pay a late enrollment penalty. This could, also, result in a higher premium as described in Question 9.

Please be reminded that you were provided with your notice of creditable coverage from the Board of Regents on October 1, 2005 . If you need another copy of your notice of creditable coverage, please call your campus Human Resources department.[/item]

[item title=”11. If I decide to enroll in a Medicare Part D plan, but I discover that I do not like that Medicare Part D plan; can I go back to my old plan with the Board of Regents?”]If you are either a PPO/PPO Consumer Choice healthcare plan participant or an indemnity healthcare plan participant, your prescription drug benefit is currently administered by Express Scripts. If you remain covered by the Board of Regents PPO/PPO Consumer Choice healthcare plan or the Board of Regents indemnity healthcare plan while you are enrolled in a Medicare Part D prescription drug plan, you may subsequently drop your Medicare Part D prescription drug coverage and access pharmacy benefits with the Board of Regents plan again.

Your Board of Regents pharmacy benefit coverage will become effective on the first day of the month after the month in which you drop your Medicare Part D coverage. You are not permitted to receive prescription drug benefits under a Medicare Part D prescription drug plan and the Board of Regents prescription drug plan at the same time.

Kaiser Permanente is currently the only Board of Regents HMO healthcare plan that offers coverage to Medicare-eligible employees. You can not enroll in the Kaiser Permanente HMO Senior Advantage option, a Medicare Advantage plan, and a Medicare Part D prescription drug plan at the same time. If you are a participant in the Kaiser Permanente HMO Senior Advantage option and you enroll in a Medicare Part D prescription drug plan, you will be dropped from the HMO altogether.

It is important that you compare the Plan Year 2006 Board of Regents prescription drug plan, including which drugs are covered, with the coverage and costs of Medicare Part D plans for your area.[/item]

[item title=”12. Does Medicare provide assistance for eligible individuals living on a limited income?”]Yes. For eligible individuals with limited income and resources, additional help paying for a Medicare Part D prescription drug plan is available. For more information, please visit the Social Security Administration website at http://www.socialsecurity.gov/ or please telephone this agency at 1-800-772-1213. TTY users should call 1-800-325-0778.[/item]

[item title=”13. Where can I get more information on Medicare Part D?”]You will receive a copy of the handbook “Medicare & You 2011” from Medicare. This book contains more detailed information regarding Medicare plans that offer Medicare Part D prescription drug coverage.

If you would like additional information, please:

  • Visit http://www.medicare.gov/
  • Call your State Health Insurance Assistance Program (please see your copy of the “Medicare & You 2011” handbook for their telephone number); or
  • Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.[/item][/accordion]