What You Need to Know

1. How will the new drug benefit work?

   If you have Medicare, you can get new prescription drug coverage beginning January 2006 in one of two ways:

   • A prescription drug plan (PDP), from a private company. You will continue to get coverage for your other medical services (such as doctor visits and hospital stays) through Original Medicare.
   • A Medicare private plan, like an HMO or PPO, that offers medical and hospital benefits in addition to drug coverage. You can enroll between November 15, 2005 and May 15, 2006 and change plans once a year between November 15 and December 31.

2. Will all my drugs be covered?

   Each drug plan will have its own list of covered drugs. You will have to pay the full cost of drugs not on the list and about 25 percent of the cost of other drugs. You must also fill your prescription at a pharmacy in your plan's network.

3. How much will I pay for drug coverage?

   You will pay a monthly premium, annual deductible and coinsurance, all of which may vary by plan. Be aware, however, that seniors must pay out of pocket for any annual drug costs between $3,600 and $5,100.

4. Do I have to get the Medicare prescription drug benefit?

   No, but unless you have drug coverage that is at least as good as Medicare's (your current drug plan will let you know) you need to enroll between November 15, 2005 and May 15, 2006 to avoid a premium penalty for late enrollment.

5. How will the benefit work with the drug coverage I now have?

   That will depend on your current coverage. Some drug insurance plans, like retiree plans and State Pharmaceutical Assistance Programs, will supplement your Medicare drug coverage. Call the company that provides your current drug coverage to find out how it will work with the Medicare drug benefit.

6. How do I find out about different drug plans?

   You can visit www.medicare.gov or call 800-MEDICARE (633-4227) to access a list of all available prescription drug plans.

Extra Help for Low Income Individuals

If your 2005 income is below $14,355 ($19,245 for couples) and your resources are less than $11,500 ($23,000 for couples) you may qualify for extra help with your Medicare drug costs.