Plan Costs

If your loved one joins the Medicare Prescription benefit, his or her costs will vary depending on which plan is chosen. In general, there is a monthly premium (generally around $37 in 2006) and a yearly deductible (up to the first $250 in 2006). Your loved one will also pay a share of the prescription drug costs, and the plan will also pay a share. Medicare helps pay for drugs up to a limit ($2,250 in total). Once the total out-of-pocket costs for drugs reach $3,600, your loved one pays 5% of the costs and Medicare pays 95% of the costs for the rest of the year.

For people with limited income and resources – including people with Medicare and Medicaid and those with income below 150% of the Federal Poverty Level (or about $14,000 in annual income) – the government will pay for many of the costs of the new drug coverage through its Extra Help program.

If your loved one did not receive information on this program, you can call Medicare or your local Social Security Administration (SSA) office to find out if your loved one will automatically get Extra Help or to fill out an application for this program. For those who are “dual eligible patients” (ie, currently receiving both Medicare and Medicaid), contact the Center for Medicare and Medicaid Services (CMS) if your loved one is having problems getting prescriptions filled.