Medicare Part D: STRS answers some questions

Questions Frequently Asked by STRS Ohio Members

From STRS Ohio News, October 2005

Q: I’ve seen television ads about the new Medicare prescription drug coverage (Medicare Part D). Should I sign up for it?

A: Beginning Jan. 1, 2006, prescription drug coverage will be available to all Medicare enrollees for a monthly premium through Medicare Part D prescription drug plans offered by private companies. All plans will provide at least a standard level of coverage set by Medicare. Some plans may offer more coverage for higher monthly premiums.

If you’re enrolled in an STRS Ohio-sponsored health care plan, you do not need to enroll in a Medicare Part D prescription drug plan. STRS Ohio has determined that the prescription benefits included in the STRS Ohio-sponsored health care plans are as good as or better than the standard Medicare prescription benefits. However, deciding if you should enroll in Medicare Part D is ultimately a personal decision. If you are considering enrolling in a Medicare prescription drug plan, carefully review the prescription drugs you are currently taking. Compare your current prescription drug plan coverage, including which drugs are covered, with the coverage and costs of the Medicare Part D prescription drug plans offered in your area.

The monthly premium for participating in the Medicare Part D Program may be relatively low. Some figures currently being quoted range from $20 to $35. However, remember that this premium covers prescription drugs only and enrollees are responsible for paying any applicable out-of-pocket costs. Also, keep in mind that your current STRS Ohio-sponsored health care plan pays for hospital/medical expenses, in addition to prescription drugs. If you terminate health care coverage under STRS Ohio, you will only have the coverage you qualify for under Medicare Part A and/or Part B unless you purchase a separate supplemental plan.

Q: What if I don’t enroll in Medicare Part D prescription drug coverage right away but later decide that I want to — is there a penalty?

A: If you are enrolled in Medicare Part A and/or Part B, you can enroll in a Medicare prescription drug plan from Nov. 15, 2005, through May 15, 2006. If you participate in an STRS Ohio-sponsored health care plan and you do not enroll in Medicare Part D during this initial enrollment period, you can enroll later without penalty. You will not be penalized because you have existing prescription coverage through your STRS Ohio-sponsored health care plan that is comparable to the standard Medicare prescription coverage. STRS Ohio will provide Medicare enrollees with a Certificate of Creditable Coverage in their open-enrollment materials that will enable them to enroll in Medicare Part D without penalty in the future. After the initial enrollment period, you will have an opportunity to enroll in a Medicare Part D prescription drug plan each year from Nov. 15 through Dec. 31.

More Medicare Part D information will be included in the health care open-enrollment packets mailed to STRS Ohio Health Care Program participants this October.