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Medicare Part D, Frequently Asked Questions

Medicare Part D Home Page

Enrolled in Medicare and Medi-Cal  |  Medicare Only

 

Medicare and Medi-Cal

    What is Medicare Part D and when will it start? 

    Beginning on January 1, 2006, Medicare will pay for all or most of your prescription drugs. This change in coverage is called “Medicare Part D.”

     

    Will Medicare Part D affect how I get my prescription drugs? 

    Yes. As of January 1, 2006, you must belong to a Medicare prescription drug plan. Your Medicare prescription drug plan will cover the cost of your prescription drugs.

     

    Do I need to sign-up for a Medicare prescription drug plan? 

    No. Medicare will put you in a Medicare prescription drug plan. Medicare will then send you a letter with information about your prescription drug plan.

     

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    What if I want to be in another prescription drug plan?

    You can change Medicare prescription drug plans for any reason. To change drug plans:

    • You must wait until November 15, 2005, and
    • You must call the Medicare prescription drug plan you want to join. That Medicare prescription drug plan will help you switch.

    Where can I get information about different Medicare prescription drug plans?

    • Ask your pharmacy which Medicare prescription drug plans it accepts.
    • Ask your doctor which Medicare prescription drug plans cover most of your prescriptions.
    • Call a Medicare counselor at 1-800-434-0222. Calls to this number are free.

    How will I know if I qualify for “extra help”? 

    Medicare should have sent you a letter saying that you qualify for “extra help.” Keep this letter. If you do not have this letter, call Medicare at 1-800-633-4227.  Calls to this number are free.

    You will get “extra help” if:

    • You paid your Share of Cost in just one month between March and December 2005. Then you will get “extra help” for all of 2006.
    • You pay your Share of Cost for at least one month of 2006. Then you will get “extra help” for the rest of 2006.
    • You meet your Share of Cost anytime between September and December 2006. Then you will get “extra help” for all of 2007.

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    If I get “extra help,” will my prescription drugs be free?

    No. You will still have a co-pay between $1 and $5. You will pay this each time you fill a prescription.

     

    What will happen if I have Medi-Cal with a Share of Cost? 

    Medicare Part D will pay for your prescription drugs as of January 1, 2006. Medi-Cal will pay for your other health care needs after you meet your Share of Cost. (Your “Share of Cost” is the amount you pay before Medi-Cal starts to pay. Your Share of Cost amount is based on how much money you make. You only pay your Share of Cost in the months you get health care services.)

    Once you meet your Share of Cost:

    • Medi-Cal will tell Medicare, and
    • Medicare will give you “extra help” paying for prescription drugs.

    What if I do not meet my Share of Cost?  Can I still get “extra help”?

    Yes, but you have to apply for “extra help.” To apply you can:

    • Go to your local Social Security or Medi-Cal office.
    • Call 1-800-772-1213.
    • Get help from your local HICAP program. You can call HICAP at 1-800-434-0222. Calls to this number are free.
    • Go to www.socialsecurity.gov . Download and complete the  “Application for Help with Medicare Prescription Drug Plan Costs.”  If Social Security sent you a letter about “extra help,” attach a copy of this letter to your application.

    I still have questions. Who do I call?

    Call us at 1-800-MEDICARE(1-800-633-4227). Calls to this number are free. TTY users can call us for free at 1-877-486-2048.   You can also call a Medicare HICAP counselor for free at 1-800-434-0222.

     

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    Medicare and You 2008 Handbook (PDF) 

    Last modified on: 7/17/2008 8:25 AM