Prescription Drug Coverage for People with Disabilities who have MaineCare and Medicare

• Information you need to help choose the right plan
  This worksheet will help you collect the information you'll need in order to choose the right plan
• Important Message for People with MaineCare and Medicare (brochure)
  Also available in (Adobe PDF*) (Microsoft Word*)(*free viewer)
• Understanding Changes in Prescription Drug Coverage for People with Disabilities on Medicare (Adobe PDF *)
  A Guide for People with Disabilities, Benefits Counselors, Disability Organizations, and Others On Transitioning to the Medicare Part D Prescription Drug Benefit
  Prepared by Jeffrey S. Crowley, Health Policy Institute, Georgetown University

SHIP (State Health Insurance Assistance Program)
Can answer questions about the new Medicare Prescription Drug Coverage

• 1-877-353-3771
• 1-800-750-5353 (voice/TTY)
• www.maine.gov/dhhs/oes/hiap/

MaineCare Pharmacy Help Desk
If you have MaineCare, you can call to ask questions about your prescription drug coverage

• 1-866-796-2463
• TTY: (207) 287-1828

• 1-800-MEDICARE or
• 1-800-633-4227
• www.medicare.gov

Benefits Specialists
Learn more about how your benefits are impacted by working or increasing your work.

• Alpha One
  • Southern Maine Regional Office:
    1-800-640-7200 (Voice/TTY)
    Central/Northern Maine Regional Office: 1-800-300-6016 (Voice/TTY)
• Maine Medical Center Department of Vocational Services
  • 1-888-208-8700
  • 1-207-662-2088
  • 1-207-662-4900 (TTY)

Protection and Advocacy for Beneficiaries of Social Security (PABSS Project)
Assistance with problems related to coverage for medications through the Medicare Prescription Drug Progam for people with disabilities who have Social Security and are in cash payment

• Disability Rights Center
  1-800-452-1948

MaineCare for people with disabilities who are working
You might be able to earn more than you think, and still receive MaineCare.

• www.maine.gov/dhhs/oes/work/welcome.htm

Is this change only for people with disabilities?

Because you already receive MaineCare, you will automatically be enrolled in a Medicare prescription drug plan that will give you prescription drug coverage. If the plan isn’t right for you, you can switch plans later. In October, you will be sent a letter to let you know which prescription drug plan you will be enrolled in. Here are a couple of examples of how this will work:

Keisha has Medicare and MaineCare. MaineCare currently covers her prescriptions. On January 1, 2006, Medicare will start to cover her prescriptions instead of MaineCare through a Medicare prescription drug plan. She waits and doesn’t choose a Medicare prescription drug plan by December 31, 2005, so Medicare enrolls her in one so she doesn’t lose drug coverage. Her Medicare prescription drug coverage begins January 1, 2006.

Martha has Medicare and MaineCare. She has never had to pay for her prescriptions because MaineCare covers them. Beginning January 1, 2006, Medicare will cover her prescriptions through a Medicare prescription drug plan instead of MaineCare. In the fall of 2005, she looks in her ”Medicare & You 2006” handbook to find out which Medicare prescription drug plans are available in her area. She gets more information from the plans and enrolls in the plan that meets her prescription drug needs. Martha will pay a few dollars for each prescription she fills at the pharmacy no matter which Medicare prescription drug plan she enrolls in.

It is important to know what prescription drugs you are currently taking and if these will be covered by the new plan. If you want to be in another plan, you can choose to switch plans starting November 15. Each prescription drug plan can cover different medications, so it is important to know if the medications you need are covered by the plan you are enrolled in. You can also talk with your doctor to see if there are any substitute medications you could take in case the ones you are currently taking are not covered by your new drug plan. Here is an example of how to switch plans:

Larry has Medicare and MaineCare. MaineCare currently covers Larry’s prescriptions. On January 1, 2006, Medicare will start to cover his prescriptions instead of MaineCare through a Medicare prescription drug plan. Larry waits and doesn’t choose a Medicare prescription drug plan by December 31, 2005 so Medicare enrolls him in one so he doesn’t lose drug coverage. If Larry feels the Medicare prescription drug plan he’s been enrolled in is meeting his needs, he doesn’t have to do anything. However, if the drug plan he was enrolled in isn’t meeting his needs, he can call 1-800-MEDICARE to find another plan and enroll in that plan at any time. Help is also available locally through the resources listed above.