| Medicare Part D - 2009 Information |
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The Medicare Part D program utilizes an annual bidding process, whereby plans submit a bid each June outlining their plans for the following year. Therefore, elements of the Part D plans can and will change from year to year. This can include changes to the formulary, plan design, premiums, copays, and other plan elements. Each plan is required to mail out a notice in October to its members that outlines any changes to their current plan. Patients are encouraged to look closely at this document and evaluate if their current plan still meets their health care needs.
In addition, the standard benefit design and low-income cost-sharing levels, as set by the government, also change each year. Below please find the new information for the 2009 plan year.
Patient Responsibility Standard Benefit Design – 2009
Deductible Phase (Drug Spend: $0–295)
Patient pays 100% = $295
Initial Coverage Phase (Drug Spend: $295–$2,700)
Patient pays 25% = $601.25
Coverage Gap (Drug Spend: $2,700–$6,153.75)
Patient pays 100% = $3,453.75
Catastrophic Coverage (Drug Spend >$6,153.75)
Patient pays ~5%
Low-Income Subsidy (LIS) Cost-Sharing Levels – 2009
*Resource limits set annually by the Social Security Administration
Important Medicare Deadlines
November 15–December 31, 2008 (Annual Enrollment Period)
During this time, patients can choose to join or switch Medicare prescription drug plans for an effective date of January 1, 2009.
January 1, 2009
If patients enrolled between November 15 and December 31, 2008, their coverage begins today!
January 1–March 31, 2009 (Open Enrollment Period)
If patients have Medicare prescription drug coverage through a Medicare Advantage or Medicare prescription drug plan, they can switch to a different plan one time only during this period.
April 1–December 31, 2009 (Special Enrollment Period)
During this time, patients can only switch or join plans if they qualify under a Special Enrollment Period such as those listed below:
• Eligible for both Medicare and Medicaid
• About to turn 65 years old
• Moving to a different coverage area
Download a 2009 Medicare Part D Pharmacist Quick Reference Guide (printable) for use in your pharmacy.
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