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You May Be Eligible to Enroll in the Medicare Drug Plan with No Penalty

The enrollment period for the Medicare Part D, the drug benefit program, ended on May 15, 2006. Those who were eligible and did not enroll have begun accruing a life-time penalty of 1% per month until the next enrollment period which begins on December 15th. You may, however, qualify to enroll with no penalty.

If you are eligible for extra help, known as the Low-Income Subsidy (LIS), you will pay no penalty, pay no monthly premium, have no annual deductible, pay a $2 co-payment for generic prescription drugs and a $5 co-payment for brand name prescription drugs. This is a considerable savings, worth as much as $3,700 a year. Click HERE (http://www.needymeds.com/indices/lis.tml) to learn the income guidelines for the Low-Income Subsidy. You can also switch plans before the enrollment period if you qualify for the extra help.

There are other situations in which you can enroll in a Part D plan with no penalty.

  • If you became eligible for Medicare after the initial enrollment period, you will be able to enroll in a drug plan for seven months - three months before and three months after the month you become eligible for Medicare.
  • If you are a younger individual who receives disability benefits from a government program such as Medicaid.
  • If you permanently move out of your prescription drug plan's service area.
  • If you move into or out of a long-term care facility.
  • If your Plan's contract is terminated or your plan goes out of business or reduces its service area.
  • If you had been permanently living abroad and return to reside back in the U.S.
  • If you lose "creditable drug coverage" through no fault of your own or this coverage is no longer as good as the standard Medicare benefit
  • If you have been released from incarceration.
  • If you can demonstrate to Medicare that your plan has not met the terms of its contract.

You can contact your local SHIP (State Health Insurance Assistance Program to get free, personal help with Medicare and Part D. Click HERE to find your state's SHIP. You may apply for the Low-Income Subsidy by calling Social Security at 1-800-772-1213.

Created 8/28/06




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