Medicare Part D Prescription Drug Benefit
At this time, many details surrounding Medicare Part D in California are still being determined and pending federal approval. As a result, the following information may change. We will continue to update you as information becomes available. If you have questions, contact us at 888 285-6334
Q: |
How do Medicare Parts A, B and C differ? |
| A: |
Medicare Part A: Covers institutional services - most Medicare eligibles are automatically enrolled.
Medicare Part B: Covers professional services - requires enrollment and premium; beneficiary portion is typically deducted from the Social Security check.
Medicare Part C: Full replacement product (Medicare Advantage) for Medicare Part A and Medicare Part B - government pays private health plans what it estimates it would have paid for Parts A and B; beneficiary must enroll in Part B; any additional premium for Part C is collected by the Part C plan.
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Q: |
What is Medicare Part D? |
A: |
Medicare Part D is a new drug benefit designed to help seniors pay for the cost of their prescription medications. The program is part of the Medicare Prescription Drug Improvement and Modernization Act of 2003. With Part D, Medicare shares the cost of the prescription drug benefit with the retiree.
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Q: |
How will the program work? |
A: |
Medicare will offer the Part D benefit by contracting with private companies, also referred to as Prescription Drug Plan Sponsors (PDPs) or Medicare Advantage Drug Plan Sponsors (MA-PDs). Medicare beneficiaries will have the opportunity to purchase the Part D benefit from a PDP in their area. This is similar to the process that Medicare used to offer the Medicare-approved drug discount card program.
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Q: |
What are Medicare Part D's key advantages? |
A: |
The Medicare Part D benefit is expected to reflect the following:
1. |
Access to a wide pharmacy network, including national chains as well as independent pharmacies |
| 2. |
Competitive discounts |
| 3. |
Point-of-sale drug claim processing |
| 4. |
Mail service |
| 5. |
Medical therapy management programs
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Q: |
Have we filed to become a Prescription Drug Plan (PDP)? |
A: |
Three of our affiliated companies have filed applications with the Centers for Medicare and Medicaid Services (CMS) to offer Part D to Medicare beneficiaries on either a regional or nationwide basis. The family of companies is currently developing Medicare PDPs to service the needs of individuals and employer groups. This action builds upon our commitment to continually develop and deliver new products to meet the nation's changing health care needs. Later this year, CMS will announce which companies have been chosen as Medicare PDPs.
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Q: |
Who is eligible for the Part D drug benefit? |
A: |
All individuals entitled to Medicare Part A or enrolled in Part B will qualify for Part D coverage.
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Q: |
When does enrollment begin? |
| A: |
An initial enrollment period (IEP) to take place from
November 15, 2005 through May 15, 2006. Beginning in 2006, new Medicare beneficiaries (those who qualify for Medicare due to age or disability) will be able to sign up for Part D during the same time they sign up for Part B.
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Q: |
Will late penalties apply if customers do not immediately enroll in Medicare Part D? |
| A: |
A late penalty will apply when Medicare-eligible individuals without creditable coverage do not enroll in Part D during their initial enrollment period. This penalty was designed to encourage beneficiaries to sign up for Part D drug coverage at the youngest possible age, keep overall program costs more affordable and to remain consistent with the penalty used for delayed enrollment into Medicare Part B.
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Q: |
Is enrollment in Medicare Part D mandatory? |
| A: |
In general, Medicare Part D is a voluntary prescription drug benefit and will not automatically be added to a customer's Medicare benefits. However, individuals eligible for both Medicaid and Medicare will be automatically enrolled.
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Q: |
What are some of the important dates I should know regarding Medicare Part D? |
| A: |
Key dates related to Medicare Part D are as follows:
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November 15, 2005 |
First Part D enrollment period begins |
January 1, 2006 |
Medicare Part D coverage begins |
| May 15, 2006 |
First Medicare Part D enrollment period ends |
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Supplemental Medicare Questions?
Call us at 888 285-6334 or visit our Medigap frequently asked questions page
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Blue Cross of California and BC Life & Health Insurance Company are Independent Licensees of the Blue Cross Association (BCA). The Blue Cross name and symbol are registered service marks of the BCA.
Anthem Insurance Companies, Inc (AICI) is the legal entity under contract with the Centers for Medicare and Medicaid Services (CMS) authorized to offer the applicable Medicare Prescription Drug (Part D) plans and services in this region. AICI is the legal entity licensed under applicable state law or under a federal waiver program that is authorized to offer these Part D plans. AICI has partnered with its affiliated local companies to provide various administrative and management services for these Part D plan(s). |
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