Social Security rep presents information on prescription plan

By Rusty Murry

Nevada Daily Mail

Richard Holder, district manager of the Nevada Social Security Office presented an overview of the new Part D prescription drug program to a group of interested seniors at the Nevada Vernon County Senior Center Wednesday afternoon.

The Neal Center sponsored the event in order to inform seniors about the new drug plan which will take effect Jan. 1, 2006. Holder outlined the basic structure of the plan, and anticipated dates of implementation. its benefits, premiums, deductibles, co-pays, income limits, resource limits, application procedures.

Holder began, saying, "anyone on Medicare, or eligible for Medicare, is eligible to sign up for Part D of Medicare; there is no income or resource guidelines that determine your eligibility."

He also stressed that he wanted to make sure that those present did not confuse the issues, and the Part D talk was about the assistance and Part D benefits.

He stated that Part D is an insurance policy just like any other policy with monthly premiums, deductibles, and co-pays. "what they built into the law, however, is some assistance and some guidelines that say premiums, deductibles and co-payments are going to be reduced for some individuals.

Those reduced costs and fees will be based on income and resource guidelines. He also said that those people who have been using the discount prescription drug card that came out a couple of years ago will have to make a decision concerning their prescription drug coverage. People who want Part D of Medicare will have to sign up before the end of the year in order to have coverage effective Jan. 1, 2006.

Medicare will choose from a number of regional vendors and authorize them to provide Part D coverage. The vendors -- which may be pharmacies, insurance companies, pharmaceutical companies or someone else who will be providing that coverage -- will be announced in September. Enrollment in the program with vendors starts Nov.15.

As it looks now, the basic cost of the plan will be about $35 but will not be more than $37. Some vendors might offer a little more than the basic plan and that cost could be reflected in a higher premium, but the premium for the basic plan will not exceed $37.

As for the basic plan's deductible, it will be $250 per year. There will be co-pays up to a point and then there is what they call "The Doughnut Hole Effect" -- a point in the plan where there is no coverage at all. The consumer will be responsible for all drug costs incurred. Any costs beyond the doughnut hole will be picked up by catastrophic insurance.

All of the specific details will be made public at a later date. In order to receive assistance in the form of reduced premiums and deductible, etc., there is a resource limit and an income limit that will impact millions of people.

"I encourage you to make out an application," Holder said, even if there's doubt about whether the individual making application will qualify.

Social Security will be mailing out letters to those that the organization knows fall within the guidelines.

The letters will be mailed throughout the summer, and anyone can get the application at the Social Security office regardless of whether he or she has received a letter in the mail.

People with supplemental plans will receive information from those providers on how they compare to Part D.

People will need to decide whether or not they need to drop the coverage. People should make decisions this fall and once they have enrolled with a vendor they will be covered for the calendar year.

Waiting until after the first of the year will mean a one percent per month penalty will be added to the premium for late enrollment.

Holder said, "it may be very important for you to decide up front, am I going to want that coverage or not, to avoid those kind of penalties."

Obviously, this program is complex, and some of the relevant information is not yet readily available. People should share the information they get with family and neighbors.

Those with questions regarding the plan may call (800) MEDICARE, 24 hours a day, seven days a week. Interested parties can also get information in the near future at www.medicare.gov.