The new Medicare prescription drug benefit known as Medicare Part D went into effect as of January 1, 2006, for all Medicare beneficiaries.  Every year (from November 15 - December 31), currently enrolled Medicare beneficiaries are encouraged to review your current plan because you will be able to switch to a different Medicare drug plan if needs have changes after your experience with your plan during 2006.  

The average deductible  for 2007 will go up slightly and the "donut hole" will begin after you have spent $2400 out of your pocket.  Catastrophic coverage will begin after you have spent $3850 out of your own pocket. For 2007, after your drug costs for the year have totalled $5451.25, you will have catastrophic coverage.

The National MS Society encourages you to review your plan NOW, consider the co-payment and premium for plans covering your medications, consider the effect of the "donut hole" on your financial circumstances, review the feasibility of a "no gap/no donut hole" plan (higher premium, no gap) if one is available in your state.  If you have had a pre-authorization or an exception to receive your medication, please check to see if you need to renew.  Also check If you need extra help with financing your plan, apply for financial assistance, look to your state pharmacy assistance programs, and drug manufacturer's pharmaceutical assistance programs.  If you are a person on Medicaid and Medicare, please review your plan to assure your continued eligibility.

The Medicare website provides tools to assist you in your review. There are some new tools on their site which should be helpful (www.medicare.gov).  Contact your National MS Society chapter if you would like some assistance in reviewing your enrollment options (1-800-344-4867)

• Medicare Home

Take the time necessary to choose the plan best suited to your needs. Just like you prepare to fill out your income tax forms by collecting certain personal information, you should enroll in a plan after you have prepared carefully. Get help from a family member or friend to compare plans online at www.medicare.gov . We recommend you check it several times as this is still new and evolving information. Or, call 1-800-MEDICARE with prepared questions.

You will need to know:

•  The name, dose and supply amount (30 or 90 days) of each prescription drug you take, which are generic or brand name drug(s), and the purpose for each one. Your pharmacist or someone in your doctor's office might help you pull this information together.

•  The source of any current drug coverage you have now, or the name of any special programs that help you with the costs of your prescription drugs.

These may include insurance from your/your spouse's current or former employer; a Medicare Supplemental (aka Medigap) plan; Medicaid, a Manufacturer's Patient Assistance Program; a State Pharmacy Assistance Program; the Veteran's Administration, TRICARE or Federal Employee Health Benefits Plan; or discount drug card or membership program. You will want to know how the coverage or help you get from any of these current sources compares to a Medicare Rx plan. Warning! Do not STOP coverage from any current source of help until you are very sure what impact it may have on your health insurance overall.

•  The name of your preferred pharmacy, and/or mail order pharmacy if you use one.

•  The actual cost of each of your prescription drugs. This will be higher than what you now pay out-of-pocket if you have some source of coverage or help with your prescription drug expenses. Check with the pharmacy that fills your prescriptions now.

Last updated October 31, 2006

From the U.S. National MS Society