I just discovered that my 83-year old mother who is in the early stages of Alzheimer's is no longer enrolled in her drug plan. I was also told that the annual enrollment period is over and that she may have to wait until next November to enroll and then pay a penalty! This is outrageous! Mom used to get her prescriptions through our state Medicaid program. Last year she was transferred into a Medicare Part D drug plan, but got "Extra Help" that paid for her costs. We didn't have to do anything. Now what can we do?
A: Last fall, the government sent letters to more than 600,000 low-income seniors and disabled people like your mother, who automatically received "Extra Help" to pay their Medicare drug coverage in 2006, telling them they would have to sign up for "Extra Help" on their own in order to receive the assistance in 2007. The program pay the cost of most or all of the drug plan premium, co-insurance, and provides coverage for the "doughnut hole" gap. Your mother's income may have been too high to qualify for automatic enrollment through her state Medicaid program this year though.
Your mother's drug plan may have tried to contact her about the change, and even may have sent an unexpected bill for the new premium that she would have to pay to remain enrolled. Then again, she may have fallen through the cracks.
If you haven't already signed the Social Medicare Prescription Drug Plan Protest Petition, please do so right now!
Your mother should re-apply for "Extra Help" right away by calling Social Security at 1-800-772-1213, or by visiting www.socialsecurity.gov on the web. It is quite possible that she may still qualify for "Extra Help" if her income is at or below 150% of the federal poverty level. In 2006, that was $14,700 for individuals and $19,800 for married couples. Individuals must have no more than $11,500 in savings or other assets and married couples may have no more than $23,000. The federal government does not count the value of her home, personal effects or her car.
If your mom is found eligible for "Extra Help," she will be able to enroll in a drug plan now and pay no penalty. If ineligible for Extra Help, then she will have to wait until the next Open Enrollment period in November, and she would be subject to a late enrollment penalty.
For folks in your mother's predicament, the federal government recently extended the enrollment period an extra three months (through March 31, 2007). This is to allow those affected by the change in "Extra Help" to shop for and switch to plans with low or no premiums. In order to find the best plan for your Mom, we strongly recommend using the Medicare Drug Plan Finder database at www.medicare.gov.
You can get one-on-one counseling and help to do both at no charge by calling your local Area Agency on Aging. You can find the number for agency nearest you in your phonebook.
January 2007
