Elder Law FAX -- May 8, 2006

Important and Timely Medicare Reminders
As a result of the Medicare Modernization Act, Medicare beneficiaries are faced with important choices and decisions. The most pressing decision involves Medicare prescription drug coverage, also known as Medicare Part D. Following are some important reminders:

1) The May 15th Medicare Part D deadline is close at hand. If a Medicare beneficiary is not already in a Medicare drug plan and does not have coverage equal to or better than Medicare's prescription drug coverage ("creditable coverage") he or she should enroll by May 15, 2006. (Coverage will begin June 1.)

2) If the beneficiary does not have creditable coverage and does not enroll by May 15th, but decides to enroll at a later date, there will be a 1 percent penalty (of base premium) added for each month that he or she did not have prescription coverage. For example, a Medicare beneficiary who waits until the next enrollment period to obtain a Medicare drug plan (November 15 through December 31, 2006) will have a permanent 7 percent penalty added to his or her premium when coverage begins on January 1, 2007.

3) Application for the Low Income Subsidy (LIS) is not subject to the May 15th deadline. Beneficiaries who qualify may apply any time throughout the year. For those who are newly qualified for the LIS, a one-time opportunity will be given to enroll in a Medicare drug plan, (although a penalty may still apply for the months without drug coverage.) Medicare will also continue to facilitate enrollment in a drug plan for people who qualify for the LIS if they do not choose a plan on their own.
The 2006 general limits are as follows:

Individuals: resources below $11,500 / income below $14,700
Married couples living together: resources below $23,000 / income below $19,800

4) Medicare beneficiaries may change drug plans one time before May 15; otherwise, they cannot switch plans until November 15 through December 31 (effective January 1 of the following year). Exceptions apply in special circumstances such as to beneficiaries who are admitted or discharged from a nursing home, and LIS recipients.

5) Recent law restricts Medicare beneficiaries from switching in and out of Medicare Advantage (MA) Plans. Medicare beneficiaries have only until June 30, 2006, to enroll or disenroll from a MA plan; otherwise, they are generally limited to making changes November 15 through December 31 of each year.

Where to go for help:
Applications for LIS are handled through the Social Security Administration, http://www.ssa.gov or 1-800-772-1213. Drug plan comparisons and enrollment may be done through the Medicare web site: http://www.medicare.gov and also through the Medicare help line, 1-800-Medicare (1-800-433-4227) open 24 hours a day, seven days a week. Callers who do not wish to navigate the automated menu selection may press zero to reach a live person. Hold time is usually less than three minutes.

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