What You Should Know about Medicare Prescription Drug Coverage
The 2008 open enrollment for Medicare Part D Prescription Drug Coverage is Nov. 15 - Dec. 31,
2007. Before selecting a prescription drug plan (PDP) or changing your coverage, the Nebraska
Department of Insurance suggests you get smart about your coverage options.
What are Medicare Prescription Drug Plans?
In 2003, the federal government enacted a Medicare prescription drug coverage benefit for
Medicare beneficiaries. Private insurance companies, whose plans have been approved by
Medicare, sell Medicare PDPs. Everyone with Medicare is eligible to enroll in a PDP,
regardless of income or assets.
What if I am already enrolled in a Medicare prescription drug plan?
Plans might change from year to year. Therefore, you should carefully examine all available
plans during each open enrollment season, as you may find that your current plan no longer
best meets your needs. Be sure to check the features of your plan, including the list of drugs
covered and the amount of premium you pay. If you are satisfied with your current plan, you
do not need to do anything to keep your plan. If you take no action, you will remain in your
What if I am enrolled in a Medicare Advantage Plan with prescription drug coverage?
Medicare Advantage plans might also make changes to important features of your plan from
year to year, including the list of drugs covered, the premium you pay, cost-sharing
requirements and provider networks. Your plan options should be carefully reviewed during
each open enrollment season. If you take no action, you will remain in your current plan.
Do I need a Medicare prescription drug plan?
A Medicare prescription drug plan may provide more coverage than a Medicare supplement
insurance (Medigap) policy or employer-provided prescription drug coverage. If Medicare
considers your employer-provided drug coverage "credible" - meaning, coverage that is as
good as the Medicare prescription drug coverage benefit - you are permitted to keep your
current coverage without incurring future penalties. Check with your employer.
What about my drug coverage through my Medigap policy?
The benefit of a Medigap drug coverage plan is generally not as good as the new Medicare
prescription drug plan, so carefully review the benefits of your Medigap drug coverage. If you
are considering a change, you will need to make a decision during the enrollment period, or
you could be subject to late enrollment penalties if you decide to enroll in a PDP later.
Nebraska Department of Insurance
402-471-2201 ~ Toll-free Consumer Hotline 1-877-564-7323
Enrollment Dates and Late Enrollment Penalties
Voluntary enrollment for Medicare prescription drug plans for 2008 began November 15 and
will end December 31, 2007. If you enroll by December 31, your new Medicare prescription
drug coverage will begin January 1, 2008.
If you are eligible, but wait to enroll after December 31, you may be subject to late
enrollment penalties. These penalties are generally 1% per month for every month you delay
enrollment. That means if you wait until March, you would pay a 3% late enrollment penalty.
There is no limit on the penalty, so the longer you wait to enroll, the higher the premium you
What are my options if I want to enroll in a Medicare prescription drug plan?
You can enroll in a stand-alone prescription drug plan (Medicare Part D) or you can choose a
Medicare Advantage plan (Medicare Part C) that includes the new drug benefit.
You will want to compare plans and select the one that best meets your individual needs.
Here are a few things to check:
ý See if all of your prescriptions are on the plan's list of drugs (called a formulary).
ý Check for your preferred pharmacy.
ý Find out what co-payments you will be responsible for paying when filling a prescription.
ý Is the premium for your preferred plan affordable?
Unfortunately, not everyone who contacts you about switching to a Medicare drug plan has
the best intentions. To protect yourself from a scam artistýs intent on taking advantage of
your situation, here are some tips to avoid becoming a victim:
ý Beware of door-to-door sales people. Agents cannot solicit business at your home without an
ý Do not let uninvited agents into your home.
ý Check with the Nebraska Department of Insurance to make sure the salesperson is a
licensed agent by calling our toll-free consumer hotline at 1-877-564-7323.
ý Do not give out personal information, such as Social Security numbers, bank account
numbers or credit card numbers to anyone you have not verified as a licensed agent. People
are not allowed to request such personal information in their marketing activities and cannot
ask for payment over the Internet. They must send you a bill. Once you decide to purchase a
plan and have verified that the agent is licensed, you may give the agent personal information
to assist in enrollment and billing.
ý Verify that the plan you have chosen is an approved Medicare plan. All of the approved plans
are available at www.medicare.gov or by calling 1-800-MEDICARE (1-800-633-4227).
Please call our office to see what Medicare Prescription RX Plan ( Part D) is best suited for your health needs. 402.312.7997