What is the Medicare Prescription Drug Program?

The Medicare Prescription Drug Program is one of the most important changes to Medicare since it was created in 1965. Approved by Congress and the President in 2003, the Medicare Prescription Drug Program will bring prescription drug coverage to more than 42 million Medicare beneficiaries across the country.

How can The Seniors Coalition help?

The Seniors Coalition has partnered with PacifiCare, which offers one of the nation's largest Medicare Advantage Plans, to bring you Prescription Solutions from PacifiCare - designed to make choosing a Medicare Prescription Drug plan easy. PacifiCare started with the basic Medicare benefit and made it even better by eliminating deductibles and providing options for the coverage gap. You'll get broad access to brand-name and generic drugs, a network of more than 50,000 pharmacies - even a convenient home delivery service!

Here's the best part - The Seniors Coalition has constructed a FREE Medicare Part D Toolkit containing all the information you need about the Medicare Prescription Drug Benefit and Prescription Solutions from PacifiCare. To receive your FREE toolkit, simply click on the button above!

How does the program work?

The Medicare Prescription Drug Program is available to everyone who has Medicare.

Under the basic Medicare Prescription Drug Program passed by Congress, you'll have:

	A yearly deductible of $250 (You'll pay this amount each year before your plan begins to pay.)
	A monthly premium of around $32 (This amount will vary by state and among private plans.)
	A copayment (your share of cost for each prescription) of 25 percent on the next $2,000 in drug costs.

Once the total drug cost paid by the plan and you reaches $2,250, you'll pay the full price of your drugs until you've spent another $2,850 out of your own pocket. This is called the "coverage gap".

After you've spent a total of $3,600 (your $250 deductible, 25 percent of the first $2000 - or $500 -, plus the additional $2,850), you'll be eligible for catastrophic drug coverage. Under this coverage, you'll pay whichever is higher - a $2 copayment for generic drugs and a $5 copayment for brand-name drugs, or 5% of the drug's cost.

Some Medicare Prescription Drug Plans offer only the basic benefit. Prescription Solutions from PacifiCare covers the cost of the $250 deductible and has a plan that eliminates the $2,850 coverage gap. (1)

Many employers who provide drug benefits may continue their drug coverage. Others may choose to help employees or retirees who enroll in a Medicare Prescription Drug Plan by paying some of the costs. Before the end of 2005, ask your former employer what you can expect. Medicare also offers special assistance for people with limited incomes.

Am I eligible?

If you're one of the 42 million Medicare beneficiaries across the country,
you're eligible to participate in the Medicare Prescription Drug Program.

Here's a look at Medicare's general eligibility rules:

	Anyone who is eligible for Medicare Part A or enrolled in Part B is eligible to enroll in the new Medicare Prescription Drug Program.
	You must live in the service area of the Medicare prescription drug plan.

Do I Need Part D?

If you're like most Medicare recipients, the Medicare Prescription Drug Program will help you save money on prescription drugs-but it won't pay for all of your drug costs. How much you'll save depends on how much you spend, either now or in the future for prescription drugs. Here are some of the things that will affect how much you will pay:

	Drug Benefits - Different Medicare plans offer different levels of coverage. Prescription Solutions from PacifiCare will help you choose the best plan to lower your overall costs for prescription drugs.
	Generic vs. Brand-Name Drugs - The brand-name drugs you're currently taking may be available in generic versions that do the same thing but cost less.
	Pharmacies - Prescription Solutions from PacifiCare has negotiated low prices at 50,000 pharmacies around the country. Benefits will apply at any of these, but not at others outside the network.

Even if you aren't taking many prescription drugs right now, remember that as people get older they're more likely to have health problems that need to be treated with drugs.  As a point of reference, the average cost of a Medicare beneficiary's drugs will exceed $3,100 in 2006. (Henry J. Kaiser Family Foundation - June 2003)

The Medicare Prescription Drug Program is optional - you don't have to sign up. You have six months beginning on Nov. 15, 2005, to enroll. You can decide to sign up later, but you'll probably have to pay more. After May 15, 2006 you'll pay the standard monthly premium plus a penalty of about 1 percent of the premium per month - or 12 percent per year. This higher premium stays with you for as long as you are enrolled in the program.  So for example, if you delay signing up for four years until 2010, your monthly premium could be $50 instead of $32.

Enrolling in a Medicare prescription drug plan now can give you the peace of mind that you'll be able to afford the drugs you need in the future-even if you don't need them today. If your doctor has told you that you may develop a health condition based on your current health or family history, a Medicare prescription drug plan may be a great choice for maintaining and improving your health.

If you currently have other drug coverage through the following programs, your current coverage may or may not continue after January 1, 2006:

	TRICARE (Military retiree benefits, VA (Veteran benefits), or FEHB (Federal employee retiree benefits)
	Employer or union retiree health plan
	Medigap Plan with drug coverage (H, I, J or non-standardized plan)
	Medicare Advantage Plan

It may not be as good as the coverage offered by the Medicare Prescription Drug Plan.  If your current coverage is not as good as the Medicare Prescription Drug Plan, called Creditable Coverage, and you decide to enroll in a Part D plan later, you may face a penalty equal to 1% of the premium for each month you delay enrollment. You should talk to your plan benefits administrator or insurer before you decide to make a plan change.

How can I receive more information?
Call 1-800-960-6310 (TTY: 1-800-730-9550) 24 hours a day, 7 days a week or click the button below to visit the Prescription Solutions website for more information on plans, coverage, and more!
Click the button below to visit the Prescription Solutions website for more information on plans, coverage, and more!		The Seniors Coalition has constructed a FREE Medicare Part D Toolkit containing all the information you need about the Medicare Prescription Drug Benefit and Prescription Solutions from PacifiCare. Click on the button below to request your FREE toolkit today!		Get all of your Part D information right from the source! Click the button below to visit the official Medicare Part D Website!
Prescription Solutions from PacifiCare Medicare prescription drug plans are underwritten by PacifiCare Life and Health Insurance Company (PacifiCare Insurance Company in the State of New York), which contracts with the federal government. Plans, programs, premiums and benefits vary by state. Network pharmacies include 46,844 preferred pharmacies and 3,697 non-preferred network pharmacies. (1) The PacifiCare Comprehensive Plan (SM) provides coverage through the gap with generic drugs.
S5921_051117D