I thought I’d start compiling my knowledge about Medicare Part D here. If you have something to add, just leave it in the comments. (See also Medicare: D Is For Disaster and Medicare Prescription Drug Calculator Tutorial for the very basics.)

1. When do I have to decide by?
   You have until December 31, 2005 to enroll in a plan that starts January 1, 2006. But May 15, 2006 at the latest, if you’re a current Medicare beneficiary. If you become Medicare-eligible in the mean time, or after these dates, you have 7 months from your 65th birthday to enroll.
2. What happens if I enroll after that?
   Unless you’re already in a drug coverage plan (from a pension benefit, for example) that is certied as good or better than Medicare Part D, your monthly premium can increase by at least 1 percent per month of delay.
3. What if I start a new drug that isn’t covered under the plan I signed up for?
   Your doctor can petition for an exception. The plan has 72 hours to determine if it will grant an exception. Denials can be appealed, but it could take awhile.
4. Can I change my plan?
   Once a year, from November 15 to December 31, you can change to a new plan. You can also change if you enter a nursing home or move to an area that your current plan doesn’t cover.
5. Will co-pays go up?
   The plans can increase co-pays or drop coverage, but they have to give a notification 60 days in advance. Unfortunately there’s no choice but to pay this increase, although a vice president of Humana claimed this “would be unlikely,” unless a drug manufacturer started increasing the drug cost.

Sources:
Millions Face a Deadline for Choosing a New Medicare Plan

3 Comments »