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Medicare Prescription Drug Coverage Changes:
Do I Still Qualify for Extra Help in 2007?

by the Disability Linkage Line Staff

Disability Linkage Line (DLL) provides free, statewide, disability-related information and assistance. DLL’s information specialists make it easier for people to explore available options, choose services, and successfully connect to those services.

The Disability Linkage Line, in partnership with the Senior Linkage Line, has helped thousands of people transition to the new Medicare Prescription Drug Program. Now it’s time to review your coverage for 2007 to make sure you are in the plan that best meets your needs, and to see if you will continue to receive the extra help with prescription costs.

Medicare Prescription Drug Plans are Changing for 2007

Everyone enrolled in a plan will receive an Annual Notice of Change from their current plan. Read this information carefully. Look for changes in costs, benefits and drugs that are covered. Just because your plan was the best plan for you in 2006 does not necessarily mean it is still the best plan for you in 2007. If nothing changed and you’re satisfied with your current plan, you do not need to do anything to stay in the plan.

If you want to change your plan, open enrollment begins November 15, 2006, and ends December 31, 2006. People who are on both Medicare and Medical Assistance can enroll and change plans beyond December 31, 2006. Medicare is encouraging people to make all plan changes by December 8, 2006, to avoid any delays with plan coverage becoming effective on January 1, 2007.

People who are getting Extra Help for the Medicare prescription drug costs, and do not want to pay any plan premium, need to choose a plan that is a “benchmark plan.” In 2007, there will be sixteen benchmark plans. Keep in mind, there are five plans that were benchmark plans in 2006 that will NOT be benchmark plans in 2007. You should research all plan options and find the best plan to cover your drug needs. To compare plans, you can go online at www.medicare.gov, or call the DLL list at bottom of page.

Review Your Extra Help with Prescription Drug Costs

People who automatically qualified for Extra Help in 2006 were Medicare enrollees who were in at least one of the following programs: Medical Assistance (MA), Medicare Savings Programs (QMB, SLMB, QI-1) and Supplemental Security Income (SSI). If you are no longer in one of these programs, you will not automatically qualify for extra help in 2007. You will need to reapply for Extra Help with Social Security to see if you still qualify based on your income and resources. You can fill out the paper application mailed to you, or you can expedite the process by filling out the application online. To apply online go to on www.ssa.gov and click on the left-hand tool bar—“Apply Here For Extra Help With Prescription Drug Costs.”

With all these changes for 2007, enrollees should receive a combination of notices from plans, Medicare or Social Security. However, some people who will no longer qualify for Extra Help in 2007 will not receive a notice telling them so. This group includes people who automatically qualified for Extra Help in 2006, were auto assigned to a plan by Medicare but chose to enroll in another plan on their own. If you have any doubt whether this situation applies to you, call the Disability Linkage Line. The Disability Linkage Line can help you find out if you need to fill out an application for Extra Help in 2007.

This article only highlights a few of the 2007 changes with the Medicare Prescription Drug Benefit.

FFI: Disability Linkage Line, 866-333-2466 from 8:00 a.m. - 4:30 p.m. Monday through Friday.



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