Supporting Information

Medicare offers prescription drug coverage for everyone with Medicare. This is called “Part D.” This coverage may help lower prescription drug costs and help protect against higher costs in the future. It can give you greater access to drugs that you can use to prevent complications of diseases and stay well.

If you join a Medicare drug plan, you pay a monthly premium. Part D is optional. If you decide not to enroll in a Medicare drug plan when you are first eligible, you may have to pay a penalty if you choose to join later.

Medicare drug plans are run by insurance companies and other private companies approved by Medicare.

There are two ways to get Medicare prescription drug coverage:

1. Join a Medicare Prescription Drug Plans that adds coverage to
   • the Original Medicare Plan,
   • some Medicare Private Fee-for Service Plans,
   • some Medicare Cost Plans, and
   • Medicare Medical Savings Account Plans.
2. Join a Medicare Health Plan (like an HMO or PPO) that includes prescription drug coverage that is a part of the plan. You get all of your Medicare health care including prescription drug coverage through these plans.

• Read Quick Facts about Medicare's New Coverage for Prescription Drugs

Medicare Prescription Drug Plans are offered by insurance companies and other private companies approved by Medicare.

They add coverage to:

• The Original Medicare Plan,
• Some Medicare Cost Plans,
• Some Medicare Private Fee-for-Service Plans, and
• Medicare Medical Savings Account Plans.

With a Medicare Prescription Drug Plan:

• Generally, you pay less for your prescriptions.
• You will get a plan member card after you enroll. You use this card when you get your prescriptions filled.
• You will pay the copayment, coinsurance, and/or deductible, if any.

If you have limited income and resources, you may get extra help to pay for your Medicare drug plan costs.

Medicare Health Plans (like HMOs and PPOs) often cover prescription drugs. Medicare Health Plans include:

1. Medicare Advantage Plans
2. Other Medicare Health Plans

Medicare Advantage Plans (like HMOs and PPOs) that include prescription drug coverage as part of the plan are health plan options that are approved by Medicare but run by private companies. They are part of the Medicare Program. If you join a Medicare Advantage Plan you are still in Medicare.

With Medicare Advantage Plans:

• You generally get all your Medicare-covered health care through that plan.
• You may get extra benefits, such as coverage for vision, hearing, dental, and/or health and wellness programs.
• You usually will have to pay some other costs (such as copayments or coinsurance) for the services you get. Out-of-pocket costs in these plans are generally lower than in the Original Medicare Plan, but vary by the services you use.
• You may have to see doctors that belong to the plan or go to certain hospitals to get covered services.
• You don’t need to buy a Medigap policy.

Medicare Advantage Plans include:

• Health Maintenance Organizations (HMO),
• Preferred Provider Organizations (PPO),
• Private Fee-For-Service (PFFS) Plans,
• Medicare Medical Savings Account (MSA) Plans,
• Medicare Special Needs Plans (SNP),

Other Medicare Health Plans

There are some types of Medicare Health Plans that include prescription drug coverage as part of the plan but that aren’t part of Medicare Advantage that are still part of the Medicare Program. With these plans, you generally get all your Medicare-covered health care through that plan.

Other Medicare Health Plans include:

• Medicare Cost Plans
• Demonstrations/Pilot Programs
• PACE (Programs of All-inclusive Care for the Elderly)

Your costs will vary depending on which drugs you use, whether you get extra help paying your Part D costs, and which Medicare drug plan you choose. Most drug plans charge a monthly premium that varies by plan. You pay this in addition to the Part B premium. Some drug plans charge no premium.

If you have limited income and resources, you may get extra help to pay for your Medicare drug plan costs.

Depending on what you can afford, you may be able to pick a pan with or without a monthly premium, deductible or coverage gap.

You can enroll in three ways:

1. Enroll online on this web site.
2. Call the plan directly.
3. Call 1-800-MEDICARE (1-800-633-4227) and Medicare will help you enroll. TTY users should call 1-877-486-2048.

• Read New Medicare Prescription Drug Coverage - Who Can Help Me Apply and Enroll?

Yes. You can change plans under certain circumstances:

• You can switch plans from November 15 through December 31 of every year.
• In special circumstances, Medicare may give you an opportunity to switch to another plan. For example, if you permanently move out of your plan’s service area; if you get help from your state Medicaid program paying Medicare premiums and/or cost sharing; if you qualify for extra help paying for prescription drugs; if the plan stops offering prescription drug coverage; or if you enter, live in, or leave a nursing home.

• Read Quick Facts about Medicare's New Coverage for Prescription Drugs

• Read The Facts About Medicare Prescription Drug Plans
• Read Other Fact Sheets about Medicare Prescription Drug coverage as it relates to the following topics:
  - Select Fact Sheets - People with Limited Income Residents of Nursing Homes/Long-term Care Facilities People who get help from state pharmacy programs People with Medigap (Medicare Supplement Insurance) Policies People who get Supplemental Security Income benefits or an MSP program Bridging the Coverage Gap  
• Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.
• Read the Medicare & You 2007 handbook mailed to you in October.