Presc. Drugs - Facts About The Proposed Prescription Drug Benefit (Copyright, Center for medicare Advocacy, Inc.)

FACTS YOU SHOULD KNOW ABOUT THE PROPOSED MEDICARE PRESCRIPTION DRUG BENEFIT

Did you know that, under the proposed prescription drug benefit currently being considered by Congress:

Unlike the current Part B premium which is the same for all beneficiaries, the premium for the drug benefit would vary. Although the media reports the premium to be $35, that figure is only an estimate. The actual premium amount will be set by each private plan and could vary among plans and in different parts of the country.
The penalty for delaying enrollment in the voluntary prescription drug benefit would be very steep. If you waited to enroll until you had high prescription drug costs, the private plan could charge a premium that reflects the actual cost of providing you with drug coverage.
You will have to get your drug benefit through a private insurance company. If you, like most beneficiaries, are in the traditional Medicare program, you still would have to go to a private insurance company to get your prescription drug benefit, offered through an insurance plan that only pays for prescription drugs. If you are enrolled in an HMO, the HMO would offer the drug benefit.
Each plan will be able to decide which prescription drugs to cover. Medicare will allow private plans to limit the prescription drugs they pay for and to decide which prescriptions to include in their formulary or drug list.
You must remain in the private drug plan or HMO you choose for one year. This "lock-in" would apply even if the private plan changes its formulary or your doctor changes your prescription to one that is not part of your plan’s formulary.
Unlike the Veterans Administration, Medicare will not be allowed to negotiate to get reduced costs for prescription drugs. The Veterans Administration saves costs for veterans and for its program by negotiating directly with drug manufacturers. The legislation under consideration specifically precludes the Department of Health and Human Services from negotiating the best drug price for Medicare beneficiaries.
The prescription drug coverage Congress is considering for Medicare beneficiaries is less generous than its own prescription drug coverage. Most members of Congress have a drug benefit that does not include the large deductible. Their insurance does not include a "doughnut hole" gap in coverage found in the proposed Medicare drug benefit, nor do members of Congress pay an additional premium for their prescription drug coverage.

Medicare beneficiaries and their families should carefully analyze proposed prescription drug legislation to understand whether it will truly be of assistance. Let Congress and the President know what you think.