Texas Seniors to Benefit from Drug Coverage Program

Texas Seniors to Benefit from Drug Coverage Program
By: Congressman Lamar Smith

October 7, 2005

The rising price of prescription drugs is a common topic of conversation among Americans. It seems that not a day or a week goes by that we don't hear stories of someone who struggles to afford needed medicines.

Unfortunately, the burden of paying high drug costs rests heavily on senior citizens, who unlike most, tend to rely on fixed incomes. To help lower drug prices for seniors and protect them against cost increases in the future, Congress passed a prescription drug coverage program in 2003 for those eligible for Medicare.

The first phase of the program, the drug discount card, has already been used by millions to save on prescription medicines. The next phase of the plan, full prescription drug coverage, will become available to seniors at the beginning of next year.

This new benefit will help Medicare recipients afford both brand name and generic medications at participating pharmacies in their area. It is also voluntary and comes with a choice of plans to help meet individual needs.

Here is some information on how the plan works:

• Anyone who is eligible for Medicare can receive prescription drug assistance. Someone qualifies if they or their spouse have worked for at least 10 years in Medicare-covered employment, are 65 years old or disabled, and a citizen or permanent resident of the United States.

- Those eligible choose a drug plan that meets their needs. They will have to pay a monthly premium. Rates vary, but average about $37 per month.

- Participants are responsible for paying the first $250 in drug costs each year. This is called the deductible. The plan will pay for 75% of drug costs up to $2,250. They will need to pay 25% of those costs.

- After someone pays $3,600, Medicare will pay for 95% of the rest of their prescription drug costs.

- This process starts over each year and extra help will be available for people with limited income and resources.

If you qualify, you do not need to make any decisions today. Information will be sent in the near future to inform you of your options. In the meantime, you can get help paying for medications through the Medicare prescription drug discount card. The discount cards can be used through the end of the year. Seniors can find out more about this card by calling 1-800-MEDICARE.

Some may already have prescription drug coverage through a current or former employer. To encourage businesses to retain and enhance employee prescription drug coverage, Medicare will offer them financial incentives.

In October, employers who provide prescription drug coverage to their retirees will directly notify them whether their current coverage is less than, as good as, or better than the new Medicare prescription drug coverage.

There are several important dates to watch for if you are eligible for the program. This fall, look in the mail for the Medicare & You Handbook with instructions on how to join a plan. To participate in this new coverage, individuals should sign up between November 15th and December 31st. This ensures that drug coverage will begin on January 1, 2006. Those who sign up for coverage after the end of December may have to wait up to one month for coverage to begin.

For more information on the Medicare Prescription Drug plan, visit www.medicare.gov on the web today.

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