Medicare Prescription Drug Coverage for Dummies (ISBN - 0470276762)

386 Pages·2021·3.67 MB·English

by Patricia Barry

Medicare Prescription
Drug Coverage

FOR
DUMmIES

‰

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by Patricia Barry

Medicare Prescription
Drug Coverage

FOR
DUMmIES

‰

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Medicare Prescription Drug Coverage For Dummies®

Published by
Wiley Publishing, Inc.
111 River St.
Hoboken, NJ 07030-5774
www.wiley.com

Copyright © 2008 by Wiley Publishing, Inc., Indianapolis, Indiana

Published simultaneously in Canada

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About the Author

Patricia Barry is a recognized expert on Medicare and its Part D prescription
drug coverage. As a senior editor of the AARP Bulletin — the newspaper and
Web site that serve AARP’s 40 million members — she’s written extensively
about Medicare from the consumer’s point of view since 1999. That year, she
went to a press conference at the White House to hear President Bill Clinton
announce his proposal to add outpatient prescription drugs to Medicare and
came away thinking: “This story has legs — it’ll run and run.” For the next
four years, she covered the bitter political battles in Washington that finally
led to President George W. Bush signing Part D into law in December 2003.

Ever since, Patricia’s mission has been to explain the controversial and compli-
cated benefit to consumers. She’s written numerous articles and guides on navi-
gating Part D for AARP publications and books. Before and after the drug benefit
went into effect in 2006, she invited readers’ questions and personally answered
hundreds of them. She continues to do so through the Bulletin’s Web site
(bulletin.aarp.org). Patricia has directly helped many, many people —
readers, friends, neighbors, and colleagues’ parents — find the Part D plan that
suits them best. Those questions and experiences are the foundation of Medicare
Prescription Drug Coverage For Dummies.

In her long journalism career in Europe and America, Patricia has written
thousands of newspaper and magazine articles and three books. A native of
Great Britain, she’s lived since 1985 in Maryland, where she and her husband
raised three adventurous children — Katerina (currently living in Russia),
Jessica (in France), and Oliver (in Egypt). In 2006, not without a sense of
mutinous disbelief, Patricia became a Medicare beneficiary herself.

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Dedication

This book is dedicated to the hundreds of older or disabled Americans who
so generously shared their personal Part D stories with me since Medicare
prescription drug coverage began. You told me what it was like on the front
lines — experiences that were good, bad, and occasionally downright ugly.
You prompted me to find answers to questions I hadn’t thought of asking.
You gave me the motivation to write this book, and I couldn’t have done it
without your insights. You were the consumer pioneers of Part D. To each
and every one — a huge thank you!

Author’s Acknowledgments

Writing this book has been a roller coaster grounded by the expertise and
wisdom of many people who kept me on track. My thanks go to experts at
two key federal agencies, the Centers for Medicare & Medicaid Services and
the Social Security Administration, who helped me through the labyrinth of
regulations that govern the Part D program and patiently answered hundreds
of questions I threw at them. I’m also indebted to experts at the consumer
help organizations who daily assist Medicare beneficiaries with Part D issues:
the Medicare Rights Center, the Center for Medicare Advocacy, California
Healthcare Advocates, and the State Health Insurance Assistance Programs.

I’m especially grateful for the advice and generously shared knowledge of
many colleagues at AARP: David Gross, Gerry Smolka, Paul Cotton, Ed Dale,
Lee Rucker, Elinor Ginzler, and, above all, Joyce Dubow, a national expert
who for many years has been my guru on all things Medicare. I thank my edi-
tors at the AARP Bulletin, Jim Toedtman and Susan Crowley, for their encour-
agement and forbearance when I needed to take time out — and my former
editors, Elliot Carlson and Bob Hey, who first twisted my arm to take on the
Bulletin’s Medicare beat.

I’m enormously grateful to my project editor on this book, Georgette Beatty,
and copy editors Vicki Adang and Jen Tucci at John Wiley & Sons, who have
been a pleasure to work with. Also to Vicki Gottlich, of the Center for
Medicare Advocacy, for her profound knowledge of Part D and vigilant eye
while acting as technical adviser during the book’s draft stages. And to my
superb agent, Maureen Watts, who got this ball rolling.

Finally, to my children (who urged me on when I felt daunted by the task) and
to my husband (whose devotion ran to cooking dinner every night for
months), I can only say: What would I do without you?

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Publisher’s Acknowledgments

We’re proud of this book; please send us your comments through our Dummies online registration
form located at www.dummies.com/register/.

Some of the people who helped bring this book to market include the following:

Acquisitions, Editorial, and
Media Development

Senior Project Editor: Georgette Beatty

Acquisitions Editor: Stacy Kennedy

Senior Copy Editor: Victoria M. Adang

Copy Editor: Jennifer Tucci

Assistant Editor: Erin Calligan Mooney

Technical Editor: Vicki Gottlich,
Center for Medicare Advocacy

Editorial Manager: Michelle Hacker

Editorial Assistants: Joe Niesen,
Jennette ElNaggar

Cover Photo: Jose Luis Pelaez, Inc.

Cartoons: Rich Tennant
(www.the5thwave.com)

Composition Services

Project Coordinator: Katherine Key

Layout and Graphics: Reuben W. Davis,
Melissa K. Jester, Christin Swinford,
Stephanie D. Jumper, Christine Williams

Proofreaders: Broccoli Information
Management, Caitie Kelly, Susan Moritz

Indexer: Broccoli Information Management

Publishing and Editorial for Consumer Dummies

Diane Graves Steele, Vice President and Publisher, Consumer Dummies

Joyce Pepple, Acquisitions Director, Consumer Dummies

Kristin Ferguson-Wagstaffe, Product Development Director, Consumer Dummies

Ensley Eikenburg, Associate Publisher, Travel

Kelly Regan, Editorial Director, Travel

Publishing for Technology Dummies

Andy Cummings, Vice President and Publisher, Dummies Technology/General User

Composition Services

Gerry Fahey, Vice President of Production Services

Debbie Stailey, Director of Composition Services

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Contents at a Glance

Introduction ................................................................ 1

Part I: The Nuts and Bolts of Medicare
Prescription Drug Coverage .......................................... 7

Chapter 1: The ABCs (And D) of Medicare .....................................................................9
Chapter 2: The Rules of the Game: How Part D Works ...............................................23
Chapter 3: The Big Question: What Will Part D Cost (And Save) You? .....................31
Chapter 4: Delving into Drug Coverage under Part D .................................................43
Chapter 5: Extra Help: A Better Deal if Your Income Is Low ......................................57

Part II: Deciding Whether to Sign Up for Part D .......... 83

Chapter 6: Taking Other Drug Coverage and Sources into Account .........................85
Chapter 7: Considering Coverage if You Take Few or No Drugs Right Now ..........105
Chapter 8: Confronting the Late Penalty ....................................................................113

Part III: Choosing and Enrolling
in the Right Part D Plan for You ............................... 123

Chapter 9: The First Cut: Deciding How You Want to Receive
Your Medical Benefits .................................................................................................125
Chapter 10: Making a Smart Choice among Medicare Prescription Drug Plans ....149
Chapter 11: Buyer Beware: Avoiding Scams and Hard-Sell Marketing....................183
Chapter 12: Signing Up for a Part D Plan for the First Time .....................................195

Part IV: You’re In! Navigating Part D
from the Inside ........................................................ 205

Chapter 13: You’ve Just Signed Up — What Happens Now? ....................................207
Chapter 14: Filling Your Prescriptions ........................................................................221
Chapter 15: In and Out of the Coverage Gap ..............................................................233
Chapter 16: Bringing Down Your Drug Costs .............................................................249
Chapter 17: Switching to Another Plan .......................................................................263
Chapter 18: Staying in Long-Term Care (Or Helping Someone Who Is) .................283
Chapter 19: You Have Rights: How to Holler and (If Necessary) Holler Louder ...293

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Part V: The Part of Tens ........................................... 313

Chapter 20: Ten Ways Boomers Can Help Loved Ones with Part D ........................315
Chapter 21: Ten Proposed Changes to Part D You Should Know About ................321

Part VI: Appendixes ................................................. 325

Appendix A: Worksheets...............................................................................................327
Appendix B: Sources of Help ........................................................................................333
Appendix C: Buying Prescription Drugs Safely from Abroad ...................................345

Index ...................................................................... 351

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