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Lynne Waihee: Champion of Children’s Literacy |
| Former first lady of Hawaii Lynne Waihee heads the Read to Me International Foundation, which helps kids succeed in life — by the book. |
Balancing Career and Caregiving |
| A Makiki resident describes how he pulls off the ultimate juggling act. |
DEPARTMENT:
Kokua Corner
Medicare Part D: Clearing Up the Confusion
Medicare Part D is a new prescription drug benefit program — the single largest change in Medicare since its inception in 1965. It is available to everyone who’s eligible for Medicare health coverage, however you must be entitled to Part A (hospital insurance) or enrolled in Part B (medical insurance) to participate. You also must live in the plan’s service area; for example, you must live in Hawaii to join a Hawaii plan.
If you applied for this benefit by December 31, your new drug program took effect January 1 and will be in effect through next January. If you joined after January 1, your coverage should’ve started on the first day of the following month. If you haven’t yet enrolled, you have until May 15 to do so, but you may pay higher premiums.
After that, the annual enrollment period will run from November 15 through December 31; in most cases that will be the only time you can add, change or drop a plan.
Part D is provided through a number of Medicare-contracted Prescription Drug Plans (PDPs), including Kaiser Senior Advantage, HMSA 65C Plus, United Health Care, MedicareComplete and AlohaCare Advantage. Medicare’s excellent Web site (www.medicare.gov) allows you to compare plans that are available in Hawaii and narrow your choices according to your individual needs.
Each plan has its own “formulary” and participating pharmacies. A formulary is a list of prescription drugs that the PDP will cover. Each PDP must meet the guidelines of Medicare and provide access to a range of drugs, both generic and name brand. The formulary does not discriminate against or discourage enrollment of certain consumers due to their age, illness or number of prescription drugs they take.
By law, certain drugs are not covered by any PDP, including those for weight loss or gain, anorexia, barbiturates, infertility, hair growth, symptomatic relief of coughs and colds, prescription vitamins and minerals, and non-prescription drugs.
If you have not yet enrolled in a plan, take the time to do your homework and ask a lot of questions. First, decide which pharmacy you’d like to use and make a list of medications you are currently taking. Next, review your monthly budget to see how much you can afford for the monthly premium and deductible. Then compare the plans available in Hawaii to find the one that best fits your needs. The State of Hawaii’s Executive Office on Aging–Sage PLUS office, (888) 875-9229, can help you assess the options.
People
with limited incomes and family assistance may qualify for help with
Medicare Part D coverage. Assistance is based on income; resources;
family size (must be related by blood, marriage or adoption); and
special situations such as grandparents raising grandchildren. Income
is determined using the rules of the Supplemental Security Income
program. Call (800) 772-1213 or check out Social Security’s
Web site at www.socialsecurity.com
to apply or request more information.
Percy Ihara is a Certified Senior Advisor. If you have questions you would like him to address, contact him at 368-6747 or toll free (866) 369-6747 from the neighbor islands.