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Live chat with Katrina Eversole

Commission of Aging's Medicare insurance specialist

Commission of Aging's Medicare insurance specialist

October 23, 2007

Our live chat with Katrina Eversole, the Commission of Aging's Medicare insurance specialist, begins today, Oct. 23, from noon until 1:00 pm. You may participate by emailing your questions or comments before and during the chat to onlinechat@herald-mail.com or by clicking here.




Moderator:

The Medicare Part D prescription program has been operating for a year now. Have there been any major problems with it so far?

Katrina: Actually, initial enrollment started in November 2005, and ended May 15, 2006. Then there was a few months before the first annual enrollment which started again in November 2006. Annual enrollments are from November 15 until December 31st each year. There were many problems, and unbelievably, the SHIP (Senior Health Insurance Program through the Washington County Commission on Aging) office is still dealing with many issues. But they are slowly being ironed out. I would say the major problem would be the Medicare beneficiaries that were "auto assigned," and found themselves in an unacceptable RX plan.

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Moderator:

If I chose a drug plan during the last enrollment session, how can I decide now whether it's still the best one for me?

Katrina: Clearly, the best way to see if you are in the least expensive Medicare D plan is to come to one of our ten enrollment events scheduled in November and December. A trained counselor will sit with you and enter your personal data into the Medicare website, and it will search the 50 plus drug plans in Maryland to see how they compare.




Moderator: If my income changes, will that affect my eligibility for Medicare Part D?

Katrina: Any person eligible for Medicare is eligible for Medicare Part D. However, there is financial help available through the local social security office, known as "Extra Help." That program is income and asset based, and you must fill out a form to qualify. Extra Help will provide financial assistance for the premium, the deductible, and the copays in your drug plan. The bottom line is that you must sign up for a drug plan whether you have financial assistance or not.




Moderator: If I sign up for Part D and still need financial help with my prescriptions, what's available and how do I apply?

Katrina: If your financial situation changes throughout the year, you always have the option to apply for "Extra Help" through social security, and you may receive 100% or partial subsidy. If you find that your drugs are very expensive and you fall into the "donut hole" during the year, there could be some help through our local MEDBANK. Also, there is state assistance through the Maryland Senior Prescription Drug Assistance Program, which has an income eligibility limit, but no asset test. This state program would allow $25 per month toward your premium. You may call our office at 301-790-0275 to request applications.




Moderator: I know there are Web sites available with information on Part D issues. Which have the best information?

Katrina: Medicare.gov is where you will find the most up-to-date information, along with the plan finder tool that allows you to do the drug searches. Also CMS.gov, which deals with upcoming events, medicare regulations, information on Medigap, and other types of insurance. You can obtain information for your specific state and county.




Patti: You mentioned that there is a "donut hole". What is that?

Katrina: The way that the medicare drug plans are designed, there is a coverage gap that occurs after you lay out-of-pocket $2500. This amount not only includes your copays for the drug, but the contracted amount that the drug companies are paying for that particular prescription through the plans. At that time, medicare stops paying and you pay retail cost for your drugs until the total out-of-pocket reaches $3600, at which time it is known as catastrophic coverage, and Medicare pays 95% of the drug cost, and you only pay 5%.




Moderator: Even though he's a senior citizen, my father is in good health and takes no prescription medicines. He tells me he doesn't need a drug plan because he will pay out-of-pocket if he needs something in the future. Is he right or should he sign up, even if he doesn't need help right now?

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