The enrollment period for prescription drug benefits through Medicare, known as Medicare Part D, began Tuesday, November 15. Anyone receiving Medicare benefits is eligible to participate in Part D. Medicare Part D enrollment is much like purchasing an insurance policy. The costs of Part D may include a monthly premium, a deductible, and co-pays for your medication. In addition, after you reach $2,500 of medication purchases, there is a gap in coverage until you reach $5,100 in drug purchases. You will be responsible for the full price of medications in this gap. The initial enrollment period is November 15, 2005 to May 15, 2006. Anyone eligible for Part D benefits who does not enroll by May 15, 2006 will have to pay a penalty for late enrollment which will be at least 1% per month. The penalty will accumulate monthly. For example, someone eligible in January, 2006 that does not enroll until May, 2007 will pay a penalty of at least 12% increase in premium (12 months of penalty from May, 2006).

There is additional assistance available for low-income beneficiaries. Additional assistance may pay for all or most of your premiums and deductibles and reduce your co-pays. Most of the people qualifying for additional assistance should have been notified in a letter from Social Security. If you believe you qualify for additional assistance, contact the Social Security office for help with enrollment. Those that have been eligible for both Medicare and Medicaid will now get their medication through Medicare. They will be automatically assigned to one of 8 plans. You will be able to change the plan you are assigned to if you prefer a different plan.

There are over 50 plans available in New Mexico. You can purchase a prescription-only plan or a Medicare Advantage plan. Medicare Advantage plans also offer medical care benefits. If you are already enrolled in Lovelace Senior Plan or Presbyterian Senior Plan, you do not have to change anything, your Medicare drug coverage will be included in your HMO benefit. If you have TRICARE, VA, Federal Retiree, Railroad Retiree, New Mexico Health Care Authority (state retiree), or IHS benefits, you already have prescription drug coverage that is equal to or better than that offered by Medicare and do not have to change. Anyone that does not currently have prescription benefits will have to enroll in a plan to get Part D benefits.

Not all drugs will be covered. Medicare prescription drug plans will all have a drug formulary. A drug formulary is a list of drugs that the plan will cover. You may want to make sure that the plan you select covers the drugs you are taking. Not all pharmacies will accept all the plans. You may want to make sure your pharmacy will accept the plan you select or into which you are automatically enrolled.

Taos Pharmacy will help our regular customers decide which plan to enroll in. Call Jake to schedule a time when you can come in. We will sit down at a computer and visit the Medicare web site and compare the plans you are considering. We can make sure it is a plan we will accept. We can even get a good idea what your drugs will cost. We can give you the information you need to enroll in the plan. We are not allowed to recommend any specific plan to you. We are also not allowed to enroll you in a plan. We can help you find the information you need to make your decision. You can also get help by calling the NM Aging & Long Term Services Department, 1-800-432-2080.

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