Similar to Part B, eligible individuals who do not enroll in Part D at the first opportunity will face a late enrollment penalty when they do join.  The late enrollee penalty is 1% for every month of delayed enrollment. They may avoid the penalty if they maintain "creditable" prescription drug coverage outside Medicare (through an employer's retiree plan, for example).  If an individual loses creditable coverage, a special enrollment period commences during which the person may join Part D without being subject to the late penalty.

 

 

Note: Gap plans H-I-J will no longer be creditable 1-1-2006.

 

 

Note:Creditable coverage in this context is different from the HIPAA definition

 

Beneficiaries who have other sources of drug coverage - through a current or former employer or union- may stay in that plan and choose not to enroll in the Medicare drug plan. If their other coverage is at least as good as the new Medicare drug benefit (and therefore considered "creditable coverage"), then the beneficiary can continue the current plan as well as avoid higher payments (penalty) if they later sign up.  Refer to www.cms.hhs.gov/medicarereform/CCguidances.asp for creditable notices. Also check our forms section.

 

Note: Plans H-I-J will no longer be considered creditable 1-1-2006.

Members will get a notice of Creditable Coverage from their employer /union explaining if their plan covers as much or more than the Medicare prescription plan. Members can keep the current plan or join Medicare Part D.  Unless the current coverage is at least as good as standard Medicare prescription drug coverage, it is important to join when first eligible as the premium will be lower than if enrollment is postponed until later.

At least two drugs in every category will be covered.

 

Excluded drugs: benzodiazepines (central nervous system depressants), barbituates (sleeping pills), drugs for weight loss or gain, to promote fertility (remember this plan covers those Medicare disabled as well as for age), for cosmetic purposes, prescription vitamins and for relief of colds.