Medicare Part D available starting Jan. 1

Starting Jan. 1, 2006, the Medicare Part D prescription drug program will be in effect for all eligible residents of the CNMI. The intent of this prescription drug program is to cover patients who are eligible for Medicare, either by age or disability, and have no other insurance to cover their prescription drugs. If a patient already has insurance coverage for their prescription drugs, then they will have to choose to either drop the prescription benefit from their current plan, or they will have to choose to not participate in the Medicare Prescription Drug Plan.

Patients will not be allowed to utilize both Medicare Part D and their current prescription drug coverage. It is very important that patients analyze each of the programs prior to dropping their current insurance to see which would be best for them. For instance, patients who take many different medications may end up paying much more under the Medicare Part D plan because of the “Doughnut Hole.” This is where the total expenditures for a patient’s prescription drugs reaches $2,250 in actual drug costs, which is determined by the prescription drug program. When this happens, the patient is then responsible for 100 percent of the cost of their prescriptions until the patient pays $3,600 out of their own pocket. After this amount, the catastrophic coverage begins and the patient is only responsible for 5 percent of their drug coverage.

For most patients who already have prescription drug coverage, depending on their premiums for such coverage, the Medicare Part D program may cost them much more than their current prescription drug plan. For patients who do not take many drugs or just a few prescription drugs per day and those patients who are very ill and take many prescription drugs per day, then the Medicare Part D program may save them money over the course of the year. Samples of co-pays for Part D that a patient may expect to pay—in addition to the $30 per month premium—are $26 per prescription for common drugs such as Lipitor and Norvasc and up to $56 per prescription for drugs such as Pravachol and Cozaar. The co-pay for all generic drugs is $5 per prescription.

Patients should analyze their prescription drug spending very carefully prior to enrolling in Medicare Part D and dropping their current insurance coverage. Patients must also be aware that they must choose between their current plan and Medicare Part D. They will not be able to utilize both insurances for their prescription drug benefits.

For patients wishing to enroll in Medicare Part D or just wishing to obtain more information, they may go on-line at www.AARPMedicareRX.com or telephone them at 1-888-867-5564 between 8AM and 11pm Eastern Time on Monday through Friday or 8am to 6pm Eastern Time on Saturdays. For questions concerning their current coverage, patients should inquire with their current insurer. (PR)