All the prescription drug plans have changed in some way. It is in every Medicare beneficiary’s best interest to shop around and find the best plan that meets their needs. For a majority of plans, there have been significant increases in the premiums and cost-sharing to be paid by the Medicare beneficiary. It is also important to compare the cost-sharing for enrollees at preferred and non-preferred pharmacies because there can be considerable differences.
Medicare's Prescription Drug Plan Finder >>

Medicare Part D information on this page:

• Important note
• Part D basics
• Re-assignment for Medicare-Medicaid and "extra help" enrollees
• Special Needs Plans (SNP)
• Get extra help paying for drugs
• Get help enrolling in a plan
• More information
  

Closing the “donut hole” for seniors

At a certain point under the Medicare prescription drug program – a point known as the "coverage gap" or "donut hole" – Medicare stops paying part of the costs of a senior's prescription drugs, requiring seniors to pay the full cost themselves. This gap will be phased out by 2020. In 2012, all seniors who reach the coverage gap will get a 50% discount for brand drugs and Medicare will pay 14% for generic drugs.

Important note about Aricept and Quantity Limits

Most plans have either taken Aricept off its list of covered drugs (formulary) or are only covering the high dose Aricept 23 mg. In addition, most plans have imposed Quantity Limits (QL) on Alzheimer's drugs. Quantity limits restricts the number of pills an individual can receive over the course of a period of time. For example, a Quantity Limit could be 60 pills for a one month period. We have raised the issue with the Medicare agency and have been told that there should not be less than the upper amount of drugs approved by FDA.

Medicare Part D basics

  Open enrollment questions and answers (7 pages)
Information from MAPRx to help beneficiaries decide to switch Medicare prescription drug plans or stick with the one they've got. Information for people with both Medicare and Medicaid.

  2012 prescription drug plan chart (1 page)
The Alzheimer's Association has developed a chart outlining which Medicare national plans do cover or do not cover Alzheimer's drugs, and which plans require prior plan approval for drugs.

 Timeline for Medicare prescription drug mailings (5 pages)
Outlines mailings you may receive from CMS (Medicare), Social Security and Medicare prescription drug plans about Medicare prescription drug coverage and what action you may need to take.

  Important things to consider when choosing a Medicare drug plan for people with Alzheimer’s disease (3 pages)
With so many drug plans to choose from, this sheet outlines important questions to consider, such as are Alzheimer's drugs on a plan's formulary and does a plan’s policies limit coverage of Alzheimer's drugs.

 Extra help for Medicare beneficiaries in paying for prescription drugs for 2012 (2 pages)
Outlines who is eligible and how to apply.

Re-assignment for Medicare-Medicaid and "extra help" enrollees

Approximately 2.5 million Medicare beneficiaries who receive "Extra Help" or who receive Medicaid benefits received a blue or tan letter from CMS regarding their current plan. Approximately 500,000 Medicare beneficiaries received a blue letter from CMS because their current plan either: 1) is leaving the Medicare program in 2012 or 2) their current plan will charge a higher premium in 2012. CMS sent a blue letter to these beneficiaries to inform them that CMS will automatically reassign them to another plan unless the individuals select new plans.

About 2 million Medicare beneficiaries who receive "Extra Help" have received a tan letter from CMS. These individuals are called "Choosers" because they selected and joined their previous or current drug plan on their own. Their plans’ premium is increasing in 2012 and this group will have to choose a new plan with a lower premium on their own or they will pay a portion of their monthly premium in 2012. CMS will not automatically assign "Choosers" to new plans.

In most states, some portion of the "Extra Help" or Medicare-Medicaid enrollees should be reassigned. The Medicare agency, CMS, has yet to release a list of the state-by-state reassignment numbers.

In 2012, there will be a 2% decrease in plans (327 nationwide) for "extra help" beneficiaries (also called benchmark plans.) The slight decrease in benchmark plans is the primarily the result of the loss of benchmark status for most plans offered by UnitedHealth. However, beneficiaries receiving the "extra help" subsidy or on Medicaid will still have options of plans from which to choose in most states.

Special Needs Plans (SNP) for Alzheimer’s disease

For 2012, there are two Medicare Special Needs Plans for individuals with Alzheimer’s disease. Special Needs Plans (also called SNPs) are Medicare Advantage plans that specialize their care and coverage for Alzheimer's beneficiaries. Only Medicare beneficiaries with Alzheimer’s disease can enroll in these plans. They are: Universal Health Care, Medicare Masterpiece Premier SNP- Dementia, an HMO available in 21 counties in Florida; and Medica Complete Solution – Dementia, an HMO available in 33 counties in Minnesota.

Get extra help paying for prescription drugs

People with Medicare who have limited income and resources may qualify for extra help paying for prescription drugs. The Social Security Administration (SSA) and Centers for Medicare & Medicaid Services (CMS) are working together to provide this extra assistance.

• People with both Medicare and Medicaid (called "dual eligibles") will automatically qualify for extra help.
• Other individuals may apply for extra help from the SSA.
  Apply online at www.socialsecurity.gov,
  or call the SSA at 1.800.772.1213 for a paper application or to make an appointment.
  

Get help enrolling in a plan

Get free one-on-one help with Medicare drug coverage and enrollment questions at State Health Insurance Assistance Programs (SHIPs). SHIPs are staffed with counselors to help people with Medicare understand the new drug coverage.
Find your SHIP counselor at www.medicare.gov

Contact the National Asian Pacific Center on Aging (NAPCA) where Asian and Pacific Island elders can call to obtain bilingual enrollment assistance and translated information.
NAPCA Web site at http://www.napca.org/

NAPCA national multilingual toll-free helpline numbers:
English: 1.800.582.4218
Chinese: 1.800.582.4218
Korean: 1.800.582.4259
Vietnamese: 1.800.582.4336

Call the The National Alliance for Hispanic Health's bilingual hotline for assistance with Medicare drug coverage enrollment. Individuals can receive help applying for low income subsidies and finding a plan to meet their needs. Call 1.866.783.2645 (Monday through Friday from 9 a.m. to 6 p.m. ET)
National Alliance for Hispanic Health