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Guide to Medicare Part D

My Income Is Limited
(Annual income below $14,355 for an individual or $19,245 for a couple)
(if No – go back)

There is a special program for people with lower incomes—above the limit for full Medi-Cal, but still below 150% of the Federal Poverty Guidelines.

My Income is Limited (but NOT on Medi-Cal)

2005 TIMELINE

May-August – You will receive a letter announcing the new Medicare Prescription Drug Coverage from Social Security – and an application for extra help with drug plan costs (financial assistance). If eligible, you will still need to enroll in a Medicare Prescription Drug plan.

November 15 – The first date that Part D plan enrollments can be accepted.

January 1, 2006 – The first day the new Part D plans will cover drugs.

May 15, 2006 – Last day to enroll in a Medicare Prescription Drug Plan without a penalty.

COVERAGE

Annual income & savings limits:*
Individual: $12,920 income, $6,000 savings
Couple: $17,321 income, $9,000 savings
Premium – Covered
Deductible – Covered
Co-Payment – $2-5 per prescription/refill
“Donut Hole” – Covered
Catastrophic – Covered

Annual income & savings limits:*
Individual: $14,355 income, $10,000 savings
Couple: $19,245 income, $20,000 savings
Premium – Reduced on sliding scale
Deductible – $50
Co-Payment – 15% per prescription/refill
“Donut Hole” – 15% co-payment
Catastrophic – up to 5% co-payment

You MUST apply to Social Security for this program. It is not automatic.

* Actual income & savings may be higher, as not all may be considered “countable” income.
Check with Social Security for more information.
HICAP
Health Insurance Counseling and Advocacy
 
Mission
 

To provide accurate and objective counseling, advocacy, and assistance with Medicare, health insurance, and related health coverage plans for Medicare beneficiaries, their representatives, or persons imminent of Medicare eligibility, and to educate the public on Medicare and health insurance issues.
 
Origins
 

The 1984 State legislation established HICAP under the Department of Aging.
 
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