Prescription Drug Coverage
Everyone with Medicare, regardless of income, health status, or prescription drug usage, now has access to prescription drug coverage.
What is Medicare prescription drug coverage?
Medicare prescription drug coverage is insurance that covers both brand name and generic prescription drugs at participating pharmacies in your area. Medicare prescription drug coverage provides protection for people who have very high drug costs or from unexpected prescription drug bills in the future.
What if I have a limited income and resources?
There is extra help for people with limited income and resources. Almost 1 in 3 people with Medicare will qualify for extra help. If you qualify for extra help you will receive help paying the premiums, annual deductible, and copayments related to the Medicare prescription drug plan, an average of $2,100 in extra help.
You should complete an application for “Extra Help” if:
- You have Medicare Part A and/or Medicare Part B, and
- Your annual income is BELOW $14,700 (single) or $19,800 (married couple), and
- Your resources are no greater than $11,710 (single) or $23,410 (married couple), which includes savings, stocks, bonds, CDs, IRAs, and other funds.
- Assets that DO NOT count include the home you live in, your car, and a burial plot and/or life insurance policy up to $1,500 each.
You can apply or get more information about the extra help by calling Social Security at 1-800-772-1213 (TTY 1-800-325-0778) or the Onondaga County Dept. of Aging & Youth at (315) 435-2362 or visiting www.socialsecurity.gov
When can I get Medicare prescription drug coverage?
- You may sign up when you first become eligible for Medicare (3 months before the month you turn age 65 until 3 months after you turn age 65).
- If you get Medicare due to a disability, you can join from 3 months before to 3 months after your 25th month of disability payments.
- Medicare Part D is not mcndatory. If you have creditable prescription drug coverage through a retirement plan, union or employment, you do not have to enroll in a Part D plan.
- If you lose your creditable coverage through no fault of your own, you will have 60 days to enroll in a Part D plan.
- If you don’t have creditable drug coverage and don’t sign up when you are first eligible, you may pay a penalty.
- If you didn’t join when you were first eligible and have no creditable drug coverage, your next opportunity to enroll will be from November 15, 2008 to December 31, 2008.
In order to help you navigate the system, the Onondaga County Department of Aging & Youth has a Health Insurance Information Counseling and Assistance Program (HIICAP) available to help.
Call (315) 435-2362. We are also providing the following links to helpful information:
www.medicare.gov
1-800-MEDICARE
TTY 1-877-486-2048
Click here to link to the Centers for Medicare & Medicaid Services - Frequently Asked Questions about Medicare Prescription Drug Coverage
Click here to link to "Medicare Interactive"
EPIC
(Elderly Pharmaceutical Insurance Coverage)
What is EPIC?
EPIC is a New York State sponsored prescription plan for senior citizens age 65+ with income no greater than $35,000 (single) or $50,000 (married couple) who need help paying for their prescriptions. Over 350,000 seniors already belong and are saving, on average, over 80% on the cost of their medicines.
Link to the EPIC website: http://www.health.state.ny.us/health_care/epic/
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