Finding a Medicare drug plan

If you're an AFT retiree, now is the time to review your current drug coverage and make any needed changes, because after Dec. 31, most people will be locked into their Medicare drug plans until 2009. And if you're verging on retirement, or responsible for a relative or friend with Medicare coverage, read on.

Everyone with Medicare can sign up for the Medicare prescription drug benefit (Part D) for 2008 or switch Medicare private drug plans between now and the last day of December.

Even if you like your current Medicare drug plan, don't assume it will work the same way next year. Many Medicare private drug plans change the drugs they cover and the cost. Plans are required by law to send you a letter by the end of October to explain any such changes. If you haven't received a letter, call your plan administrator and ask for one.

Whether you are evaluating a current plan or shopping around for a new one, here are several things you should keep in mind:

• Different Medicare drug plans cover different prescriptions at different costs and are accepted at different pharmacies. Before you sign up for a plan, call the plan and make sure it covers your prescriptions and is accepted at your pharmacy. Also, ask whether the plan places any restrictions on the drugs you take.
• Find out how much you will have to pay for your medications. Many plans have a gap in coverage known as the "doughnut hole," during which you must pay the full cost of your prescriptions. With most plans in 2008, the gap will begin when your total drug costs (what you pay plus what your plan pays) reach $2,510. In all plans, the coverage gap ends and catastrophic coverage begins after you have spent $4,050 out of pocket; you then pay no more than 5 percent of the cost of each drug. In most states, you can buy a plan that offers some coverage through the gap. These plans generally have higher monthly premiums, and most cover only generic drugs.

People with low incomes may be eligible for Extra Help, a federal program that will help pay for some or most of the costs of prescription drugs. These indi-viduals can apply through the Social Security Administration by using its print or online application or at your local Medicaid office.

If you have drug coverage from another source—such as an employer or a retiree plan—and are considering the Medicare drug benefit, first find out if your coverage is as good as Medicare's. (Many such plans provide better benefits than Part D plans.) If your employer or retiree plan is at least as good as Medi-care's and you like your plan, you don't have to do a thing. Even if you later decide to get drug coverage through Medicare, you will not have to pay a penalty.

If you have health or drug coverage and want Medicare drug coverage, make sure, your current coverage will work with the Medicare drug benefit. Some health and drug plans don't allow you to have Medicare drug coverage as well, or only work with certain types of Medicare drug plans.

If you are considering a Medicare drug plan for the first time, be aware that you have to pick a plan that works with your Medicare health coverage. If you do not enroll in the Medicare drug benefit when you first become eligible, and have not had drug coverage that is as good, you may have to pay a premium penalty for postponing enrollment.

To learn more about Medicare drug coverage, how to find the right drug plan or how Medicare drug coverage works with state pharmaceutical assistance programs, log on to www.medicareinteractive.org/teachers, brought to you by AFT and the Medicare Rights Center.