TransparencyMedicare Part D
The Medicare Part D prescription drug benefit program was enacted as part of the Medicare Prescription Drug Improvement and Modernization Act of 2003 and officially began on January 1, 2006. Consumers who are dual eligible, have both Medi-Cal (Medicaid) and Medicare, were automatically enrolled in a Medicare Part D plan. Dual-eligible individuals who were automatically enrolled into a Part D plan in 2006 can continue to remain in that plan in 2007 unless they opt into a different one. They can also change plans every month if needed to obtain necessary coverage for newly prescribed medications by calling 1-800-MEDICARE.
Dual eligible individuals are not subject to deductibles, gaps in coverage, or monthly premium payments for their Medicare Part D plan, but are responsible for co-payments. During 2006, monthly co-payments for generic medications were $1 and for brand name medications were $3. For 2007, the generic co-payment will remain at $1, but the brand name payment will increase to $3.10. Dual eligible individuals who reside in nursing homes do not pay co-payments for their medications. A pharmacist can waive or reduce the cost-sharing amount for a low-income individual provided the pharmacy has not advertised that the waivers or reductions of cost sharing are available. If you have any further questions regarding Medicare Part D, please contact your Service Coordinator.
See Medicare FAQs
Medicare Part D Forms
Blue Cross Medicare Rx Application