Prescription Drugs

Most seniors now have a Medicare D policy or have better drug coverage through their retirement health plan.  The Medicare D plan offers

• $295 annual deductible
• 25% co-insurance on formulary drugs between the deductible and the initial coverage limit of $2700
• From $2701 to $4350 seniors pay 100% of prescription drug, for a total of $5100 out of pocket
• Catastrophic coverage of no more than 5% co-insurance for formulary drugs 

Most Medicare D plans cover the "donut hole" from $2701-$4350 but most don't.  You may only change plans from November thru January of each year.  Use Medicare's Prescription Drug Plan Finder to determine which is the best plan for the drugs you are on.  Note Medicare Advantage Plans replace your traditional Medicare coverage.  You can get your prescriptions at almost any pharmacy.  Veteran's are often better off getting their prescriptions through the VA.

Some seniors may also be eligible for Extra Help to help pay for monthly premiums, annual deductibles and prescription co-payments. The 2009 yearly income limits are

• Income les than $16,245 and resources less than $25,010 - Single person
• Income less than $21,855 and resources less than $25,010 - Married person living with a spouse and no other dependents

If you qualify for "Extra Help" you will likely get help with paying your monthly premium or a reduced premium, your deductible, coinsurance, copayments and there would be no coverage gap or "donut hole".

If you are already on Medicaid, or get help paying your Part B premiums or are on SSI you will be automatically enrolled in the Extra Help program.  Will will have to join a Medicare D plan to get the extra help.  If you didn't automatically qualify you can call Social Security or apply at on-line. 

For further questions on Medicare D plans in Indianapolis contact your local SHIP office.

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