May 25, 2006

Q: My grandmother has Medicare Parts A and B and wants to sign up for a Medicare drug plan but says the monthly fee is too high. Her only source of income is a Social Security check which is $805 per month, and she has less than $6,000 in her savings account. Does she qualify for the Medicare drug benefit? Can she get help with the monthly premiums? -- Anne

Dear Anne,

Your grandmother, like everyone on Medicare, regardless of income, is eligible to receive the Medicare drug benefit, if she chooses to enroll in a Medicare drug plan. In addition, based on your description of her income and assets, it sounds like she will also qualify for financial assistance available to help beneficiaries pay for the drug benefit. If she qualifies, Medicare would pay all or most of her Medicare drug plan premium, and she’d pay only a small copayment (no more than $5) for each of her prescriptions.

Even though the May 15 enrollment deadline has passed, she can still apply for the low-income assistance by contacting the Social Security Administration or her state’s Medicaid office. If she is found eligible, she will have a one-time opportunity to sign up for a Medicare drug plan as soon as she learns from Social Security that she qualifies for this extra help. Under these circumstances, she will not face a penalty for late enrollment. 

If she does not sign up for a Medicare drug plan on her own, Medicare will automatically enroll her in a plan and will send her a letter to let her know which plan will be covering her prescriptions for the remainder of this year. If she is not satisfied with the plan, she can switch to a different plan once before the end of the year.

The additional help for people with low income is very valuable, so it would be a good idea for your grandmother to apply as soon as she can.  

This column was prepared by the Kaiser Family Foundation, an independent, non-profit private foundation based in Menlo Park, Calif., that is not affiliated with the Kaiser Permanente health plan. Do you have questions about the new Medicare drug benefit? Send your questions to Medicare Q and A. The Kaiser Family Foundation. 1330 G St., NW. Washington, DC  20005 or MedicareQ@kff.org. 

(c) 2006, Knight Ridder/Tribune News Service.

Distributed by Knight Ridder/Tribune Information Services.