For Release: IMMEDIATE
Date: November 8, 2005

Medicare Prescription Drug Plans: Helping a family member with their decision

Family caregivers can play a critical role in helping family members on Medicare make a decision about the new Medicare Part D Prescription Drug Plans (PDP). You have probably already heard of the new PDPs through friends, commercials, or mailings. There’s a lot of information targeted to seniors and baby boomers. Hopefully, you’ve been thinking that it may pertain to you or your relatives and if you haven’t already, you may need to talk to your relatives about some intimate information. But how do you start if you don’t know anything yourself?

Plan ahead: What everyone needs to know

• Each person’s situation needs to be assessed to determine the need to enroll in a Medicare prescription drug plan. Everyone’s situation is different, and there will be questions about eligibility. Those questions can be directed to the contacts listed at the end of this article.
• Because Medicare Part D is a new program with many variables, it can be a challenge to figure out the best decision. Among all the confusion, there are a few things to consider that might help clarify your questions:
• If your family members have no prescription drug coverage, they should consider signing up for a plan during the enrollment period, whether or not they are currently taking any prescription medications. Otherwise they may later face a 1 percent per month higher premium due to a late signup penalty.
• If your relatives have prescription insurance coverage through an employer (retirement) that is equal to or better than the Medicare standard benefit, they may be able to stay in this plan and avoid the 1 percent premium penalty. The federal law requires the employer to send a notice by Nov. 15, 2005 of whether or not their coverage is as good as, or better than the Medicare standard benefit.
• Some beneficiaries will qualify for extra help in paying for the PDP premiums and their medications. People receiving government assistance with prescription drugs such as Medicaid should have received a letter in October informing them of the plan they will automatically be enrolled in unless they enroll in another plan before Dec. 31, 2005. Others may be eligible for this help if they meet certain financial guidelines.

There are 38 plans being provided in North Carolina. You and your relatives must find one that best fits in regards to the medications they take and what pharmacy they prefer.

Medicare beneficiaries may be getting a lot of information from many different organizations and insurance companies that are rushing them to sign up. The enrollment period begins Nov. 15 and lasts until May 15, 2006, so there is time to talk with your relative and research the plans available. If someone enrolls by Dec. 31, 2005, the new Medicare Prescription Drug coverage will begin on Jan. 1, 2006. If possible, do not wait until after the May 15 date. There will be a 1 percent penalty for each month an eligible person does not sign up after May 15.

Broaching the subject: Helpful hints

No matter how close you are to your family member, there may be some subjects that are difficult to discuss. Talking about Medicare Part D includes two sensitive topics: your parents’ or relatives’ finances and what drugs they take. There are some things you can do to make the most of the conversation.

As stated above, prepare what you want to talk about and what information you need to get from the conversation. If you need to broach the subject, it may be easier to work it into a normal conversation. Often, someone will pay more attention if you bring up a difficult topic with a story or something unrelated directly to them. You can use daily activities to bring up the subject of Medicare Part D, such as watching TV, talking about friends, and reading a newspaper article or the mail. Talk about what a friend is experiencing trying to find out what’s going to happen to their prescription drug coverage or an insurance commercial you just saw.

Once the subject is up for discussion and your family members understand that they may need to enroll in a Medicare Prescription Drug Plan you will need to learn certain things about their situation and the Medicare PDP. You will need to know about the prescription drug coverage your relative currently has; brand and generic names, frequency and dosage, and cost of the prescription drugs they are taking; and what pharmacy/pharmacies they prefer. Remember that some people may qualify for assistance in having their medications and premiums paid for if they meet certain financial criteria.

Getting help: Sources of information

For information on the Medicare Part D and North Carolina specific information contact:

• The Seniors’ Health Insurance Information Program: 1-800-443-9354: www.ncshiip.com .
• The North Carolina Division of Mental Health, Developmental Disabilities, and Substance Abuse Services has information on their website: http://www.dhhs.state.nc.us/mhddsas/medicare-d/ .
• Medicare’s website: www.medicare.gov —look at the Medicare & You 2006 Handbook.

Other helpful places to go to: the Social Security Administration Office: www.socialsecurity.gov And, your local pharmacy.

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