| North Carolina Physician Medicare Part D Primer |
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Note: An Excellent Website called My Medicare Matters by
The National Council on Aging provides similar information
(with the option to view their site in larger text size).
1.) Whether to apply for financial assistance or "Extra Help"
<$11,500 (single person) or <$ 23,000 (couple) you may qualify for extra help.
If you meet BOTH of the above requirements, AND APPLY with the Social
Security Administration, you should get "extra help" (a subsidy) to pay for your
drugs if you sign up for a Part D plan.
See UNC School of Pharmacy table.
2.) Whether to enroll in a plan at all
The links below will show you all the plans in NC, but the best way to find which plan
best fits your needs is to use the Medicare Plan Finder Tool.
Stand Alone Prescription Drug Plans in North Carolina (Lists all 38 PDPs)
Medicare Advantage PDPs in North Carolina (Lists all 15 MA PDPs)
CONSUMER INFORMATION-- PROTECT YOURSELF
1.) Be aware that it is legal for marketers of these Drug Plans to "cold call" you at home.
However, they must abide by "Do not call again" requests. To stop calls effectively
down the time & date, and name & company of the person you are speaking with. If anyone
from their company calls again report it to the NC Division of Insurance 1-800-443-9354
2.) Also BEWARE that scam artists and identity thieves may take advantage of the Part
D calls and try to obtain Medicare numbers, Social Security numbers, or other sensitive
information. DO NOT GIVE SENSITIVE INFORMATION TO ANYONE WHO CALLS YOU
ON THE PHONE. For your protection, the law states that in order to enroll, YOU must call
the PLAN. If you want to sign up for a plan described to you over the phone, get the name
and number of the person and organization, check it out with NC Division of Insurance and
then call the plan back later with the necessary information. If you think your personal
information has been stolen or misused call 1-800-MEDICARE or the
Federal Trade Commission Identity theft office 1-877-438-4338 (TTY 1-866-653-4261).
The National Council on Aging provides similar information
(with the option to view their site in larger text size).
1.) Whether to apply for financial assistance or "Extra Help"
- What is your annual income?
- If your annual income is < $14,355 (single person) or <$19,245 (couple)
then you may qualify for financial assistance if you apply with SSA.
- What are your assets?
<$11,500 (single person) or <$ 23,000 (couple) you may qualify for extra help.
If you meet BOTH of the above requirements, AND APPLY with the Social
Security Administration, you should get "extra help" (a subsidy) to pay for your
drugs if you sign up for a Part D plan.
See UNC School of Pharmacy table.
2.) Whether to enroll in a plan at all
- Would you take prescription medications if prescribed?
- (About 10% of seniors say no-- Part D will only benefit people who
use prescription medicines.)
- What is your current prescription drug coverage?
- Medicaid- You will be automatically enrolled in a Part D plan but can
choose to switch plans if you find another plan better suits your needs.
Choose from among the 13 plans listed on the "Medicaid + Medicare" page to
avoid paying a monthly fee. Keep your enrollment letter and any mail from
Medicare or Social Security to take to your pharmacist with questions.
Employer- If you received a notice from your insurer that says your current
coverage is "creditable" or "as good or better" than the Part D plans,
keep your current coverage and do not worry about Part D now.
Medigap- You will likely receive notice that your prescription drug
coverage is "NOT creditable" or "NOT as good or better than the Part D
plans. If this is the case you should drop the prescription drug coverage
part of your current Medigap plan and enroll in a Part D plan.
None- If you take prescription drugs you may benefit from enrolling
in one of the plans depending on your annual drug costs.
- How much do you spend on drugs on an annual basis?
- >$850- You will likely benefit from signing up for a Part D plan now.
$400-850- You might not benefit from signing up for a Part D plan this
year, but if your drug costs increase, and you try to sign up later
(and do not have creditable coverage) you will pay a 1% increase in
your premium for every month you delay signing up after May 15, 2006.
<$500- You have the most difficult decision. Whether you sign up for a
plan will depend on whether you or your doctor feel it is likely that you
will ever need to take >$500-800 per year worth of drugs. If you do not
have creditable coverage, then not signing up is playing the odds, as
the penalty for later sign-up could be significant. Sign up for the lowest
premium plan you can find for now.
- Which drugs do you use? (You will need your current drug list.)
- Go to www.medicare.gov and use the PLAN FINDER TOOL to find the plan
that covers the drugs you take. With your doctors OK, you may be able
to decrease costs by using more generic drugs.
- Do you prefer to get your care from a particular provider or hospital?
- Be aware that the Medicare Advantage plans may not pay for services
at all hospitals and doctor's offices in your community. Find out
specifically if your preferred providers are covered before signing up.
- Do you want to use a particular pharmacy?
- Many plans will limit your choice of pharmacy or charge more for a non-
preferred pharmacy. Be sure you can use the pharmacy you prefer with the
plan you choose. If you use mail-order make sure it is available on your plan.
The links below will show you all the plans in NC, but the best way to find which plan
best fits your needs is to use the Medicare Plan Finder Tool.
Stand Alone Prescription Drug Plans in North Carolina (Lists all 38 PDPs)
Medicare Advantage PDPs in North Carolina (Lists all 15 MA PDPs)
CONSUMER INFORMATION-- PROTECT YOURSELF
1.) Be aware that it is legal for marketers of these Drug Plans to "cold call" you at home.
However, they must abide by "Do not call again" requests. To stop calls effectively
down the time & date, and name & company of the person you are speaking with. If anyone
from their company calls again report it to the NC Division of Insurance 1-800-443-9354
2.) Also BEWARE that scam artists and identity thieves may take advantage of the Part
D calls and try to obtain Medicare numbers, Social Security numbers, or other sensitive
information. DO NOT GIVE SENSITIVE INFORMATION TO ANYONE WHO CALLS YOU
ON THE PHONE. For your protection, the law states that in order to enroll, YOU must call
the PLAN. If you want to sign up for a plan described to you over the phone, get the name
and number of the person and organization, check it out with NC Division of Insurance and
then call the plan back later with the necessary information. If you think your personal
information has been stolen or misused call 1-800-MEDICARE or the
Federal Trade Commission Identity theft office 1-877-438-4338 (TTY 1-866-653-4261).
| Part D 3 Main Decisions for Patients (Also see NCSHIIP Tip Sheet) |
Email holly.biola@gmail.com for updated
info. This site will be taken down 12/31/08.
info. This site will be taken down 12/31/08.
Email holly.biola@gmail.com for updated
info. This site will be taken down 12/31/08.
info. This site will be taken down 12/31/08.