Medicare prescription programs available to all

For most Americans, particularly those of Medicare age, prescription drug coverage is one of the most important issues in their lives. The reasons are obvious, the medications we need more and more to remain healthy as we age are taking ever increasing bites out of what we may have believed to be adequate funds for our "golden years." In short, the gold we saved and planned for just isn't enough to provide for our needs.

At last, Congress and the president recognized the necessity of providing senior citizens with some assistance in paying the staggering cost of prescription drugs by passing and signing a Medicare prescription drug bill. Beginning Jan. 1, 2006, everyone who is Medicare eligible whether because of age or disability will have access to some form of drug coverage.

The program, true to form for anything governmental, is not automatic and is not necessarily simple. However, there is plenty of help as we all become familiar with the program, its implementation, and how we as individuals can ensure that we receive the benefits we are entitled to.

Some basic dates need to be highlighted on your calendar and some processes will be taking place, generally by mail. If you are of Medicare age or eligibility watch for information from Social Security. Another thing you should receive, in October, is information from your provider of prescription drugs, if you have one. Under the new law, they have to contact you and let you know how your plan compares to the new Medicare drug plan. If yours, from a former employer, union or other source, is better, you may want to stay with it, particularly if dropping it could interrupt your medical coverage through them.

You may already have received an announcement about the program by mail with notification of informational meetings at senior centers in your area. There have been several at the Sandpoint Senior Center and they are conducted by representatives of the Social Security Department and Senior Health Insurance Benefit advisors, a branch of the Idaho Department of Insurance which is in place to help implement the new plans. No local meetings are scheduled at present, but more could be if there is interest.

I attended one of the meetings so that I could share with you what I learned and most importantly let you know whom to contact for complete information. For SHIBA, your contact is Gwen Hecket at 1-800-247-4422. She is a wealth of information and explains things clearly and will find answers to your questions. The Social Security contact number is 1-800-772-1213. That number is to request an application for the assistance program. 1-800-MEDICARE (1-800-633-4227) will help you learn more about the prescription drug plan.

Again, coverage is not automatic. Everyone must apply for the assistance. Applications are available at most senior centers, including Sandpoint.

Social Security may provide complete or partial help with drug costs, depending on income, number of persons in your household, and assets. Those already determined to be eligible for Medicare and Medicaid will automatically qualify for the new program.

Some dates that are critical to the drug assistance program are Nov. 15, 2005. That is the first date for application, although you are wise to obtain an application now and if necessary, get help filling it out. The final date for application is May 15, 2006. Applications after that will cost an additional 1 percent per month of your required percentage of co-payment until you apply. Clearly, you do not want to miss that date.

If you would prefer to apply online, you can do that now at www.socialsecurity.gov.

If you need immediate financial assistance with your prescriptions, SHIBA may be able to help with the cost your drugs between now and Jan. 1 when the programs begin. Some funding is available for that purpose.

Obviously I cannot begin to cover the complexities of this long awaited prescription drug coverage in this column. Just remember that application for assistance and joining one of the drug plans must take place between November 15, 2005, and May 15, 2006, to avoid expensive penalties.

Also, be assured that an army of professionals and volunteers is ready to help you understand the new benefits and apply for the assistance due you. Everyone of Medicare age will be eligible for a prescription drug plan. You need to join one of the plans about which you will receive information by mail. The variations will be in your financial situation and your ability to pay proportionate to your finances. Social Security will assess your application to determine your benefits, but first you must apply.

In researching this topic, I got a warning from U.S. Sen. Larry Craig's office that I want to pass along. There are bad guys trying to take advantage of seniors with scams associated with the new drug programs. If anyone asks you for money, contact law enforcement or even Senator Craig's office who will pass the information on to federal officials. There is no legitimate reason for anyone to ask you for money and it is surely a scam.

This guaranteed drug coverage is the best thing for seniors since Medicare was passed in the 1960s. You are entitled. Any confusion can be cleared up with a phone call or two and it will be one less thing adding worry to those golden years you keep hearing about.