Transcript Medicare Part D - Ben Franklin Apothecary

Medicare Part D
Prescription Drug Program
Adapted from a presentation by the Social Security Administration
Presented by:
Ben Franklin Apothecary
Dan Jespersen - Pharmacist
Month 00, 2005
Medicare Basics
• Medicare provides health insurance for:
– Individuals 65 and older
– Disabled individuals entitled to Social
Security benefits for 24 months
– People who have permanent kidney failure
– People who have Lou Gehrig’s Disease
Insert Logo Here
Parts of Medicare
• Part A
– Hospital Insurance
• Part B
– Supplementary Medical Insurance
• Medicare Advantage
• Prescription Drug Program
Insert Logo Here
Medicare vs. Medicaid
• Medicare
– Administered by Federal Government
– Same benefits throughout U.S.
– Eligibility not related to financial need
Insert Logo Here
Medicare vs. Medicaid
• Medicaid
– Administered by Federal Government and
State
– Differs from state to state
– Eligibility related to financial need
Insert Logo Here
MMA: Medicare Prescription Drug,
Improvement and Modernization Act
of 2003
• Drug Discount Card
– 5/3/04 through 5/15/06
• Medicare Part D
– Prescription Drug Program
– Effective 1/1/06
Insert Logo Here
Medicare Part D
Prescription Drug Program
• What is it?
– Provides prescription drug coverage under
Medicare
– Allows eligible applicants to receive extra
help paying for monthly premiums,
deductibles and co-payments
Insert Logo Here
Medicare Part D
Prescription Drug Program
• Who can qualify for extra help?
– Individuals already on Medicare Part A
and/or Medicare Part B
– Individuals with an annual income below
$14,355
– A married couple living together with an
annual income below $19,245
Insert Logo Here
Medicare Part D
Prescription Drug Program
• Eligibility also depends on resources like:
- Stocks
- Bonds
- Bank accounts
- Real estate other than primary property
Insert Logo Here
Medicare Part D
Automatic Enrollment
• Who is automatically enrolled?
– Individuals with Medicare and who receive
Supplemental Security Income (SSI)
– Individuals with Medicare who receive
Medicaid with prescription drug coverage
• These people do not have to apply for
extra help, they will automatically receive
it
Insert Logo Here
Medicare Part D
Application
• When will possible eligible beneficiaries
receive their application?
– May 27 through August 16, 2005
– They are sent according to Social Security
Number
– People living in the same area will not receive
applications at the same time
Insert Logo Here
Medicare Part D
Application
• Possible beneficiaries should fill out their
application in a timely manner before
returning it
• Once it has been received by the SSA they
will get a receipt in the mail
• Possible beneficiaries will be notified whether
or not they are eligible about 4 weeks after
they get the receipt
Insert Logo Here
Medicare Part D
When Does the Program Start
• If the beneficiary is deemed eligible before
December 31, 2005, their services will start
on January 1, 2006
• End of initial enrollment is May 15, 2006
– If the beneficiary does not enroll in a plan
before this date, they will be subject to a
late enrollment fee
• Eligible applicants who are approved after
December 31, 2005 can start to use the
discount drug program one month later
Insert Logo Here
Pharmacy’s Role
• Resource for information
– Answering questions about Medicare Part D
– Help filling out the application
– Helping customers assess their prescription
drug needs
SOURCE: http://www.ssa.gov
Insert Logo Here
Ben Franklin Apothecary
302 North Main Street
Duncanville, TX 75116
(972) 298-4936 phone
(972) 296-9844 fax
Insert Logo Here