Open enrollment season for Medicare Part D starts

[November 17, 2008]  CHICAGO -- Seniors and other Medicare recipients throughout the country can now change their prescription drug coverage as part of Medicare Part D's open enrollment season. Gov. Rod R. Blagojevich is encouraging eligible Illinois seniors to make time to review their current coverage and also to apply for Illinois Cares Rx. Illinois Cares Rx provides prescription drug coverage that fills in gaps created by Medicare Part D and also provides drug coverage to people who do not have Medicare.

Blagojevich signed the "No Senior or Person with Disability Left Behind" law in 2005, creating the Illinois Cares Rx program, the nation's most comprehensive response to fill in the gaps created by the federal prescription drug program. Illinois Cares Rx has provided extra assistance to thousands of Illinois Cares Rx members and other Medicare beneficiaries.

"During these difficult economic times, families are making sacrifices in order to put food on the table or even to just keep the lights on," Blagojevich said. "Many seniors and people who have disabilities are forced to go without their medications because they can no longer afford to pay for them. I strongly urge people with disabilities and seniors to find out if they may qualify for Illinois Cares Rx so that they get those medicines and stay healthy."

During the "open enrollment season," which started Nov. 15 and runs through Dec. 31, Medicare beneficiaries can change their Medicare Part D plans. Illinoisans enrolled in Medicare should review their current plan to determine whether there is another plan that would best address their health and financial needs. Illinois seniors and people who have disabilities can apply for Illinois Cares Rx at any time during the year.

In 2009, the standard federal Medicare Part D prescription drug program will pay 75 percent of prescription drug costs up to $2,700 after a $295 deductible, with a regional average premium of $30.18 per month. Beneficiaries are responsible for all of their costs between $2,700 and $6,153.75, with the plan paying 95 percent of costs beyond that top threshold. The gap where a beneficiary has to pay all the drug costs, between $2,700 and $6,153.75, is commonly referred to as the "doughnut hole." Illinois Cares Rx provides a safety net for seniors and people with disabilities so that their out-of-pocket costs do not increase when they are in the doughnut hole.

To receive Illinois Cares Rx benefits, Medicare-eligible members must be in a Medicare Part D plan coordinating with Illinois Cares Rx. Several Medicare Part D stand-alone prescription drug plans are coordinating with Illinois Cares Rx in 2008. There are also a number of Medicare Advantage companies coordinating with Illinois Cares Rx this year. The stand-alone prescription drug plans are available statewide. Medicare Advantage prescription drug plans may be available only in certain areas of the state.

Individuals eligible for the Illinois Cares Rx program may also be eligible for additional wraparound benefits from the state's Circuit Breaker program. The Circuit Breaker program provides a property tax relief grant for certain individuals in addition to an annual $54 discount on the license plate fee for one vehicle. These benefits, including Illinois Cares Rx, can be accessed by applying on one application.

Individuals applying for Illinois Cares Rx online should have the following information available: Social Security numbers, amount of property taxes paid in 2007, amount of rent paid in 2007 and a copy of 2007 federal tax returns. Individuals can file their 2007 applications through the end of the year. However, the 2008 application will not be made available until mid-January 2009.

New federal rules are meant to protect consumers against marketing fraud in the sales of Medicare prescription drug plans and Medicare Advantage plans. According to these new rules, individuals who contact people about any type of private Medicare coverage:

• Must be licensed by the state.

• May not make unsolicited contacts with prospective beneficiaries, such as door-to-door sales, cold calls or approaching you in a parking lot.

• Must have an appointment in advance before coming to your home.

• Must arrange with you in advance about the type of products that will be discussed during a scheduled sales appointment. At the appointment, the salesperson may not try to sell you other types of insurance coverage other than the types agreed upon in advance.

• May not try to sell you products not related to health care (such as a life insurance policy or an annuity) during a sales or marketing presentation of a Medicare prescription drug or Medicare Advantage plan.

• May not attempt to sell you a plan in certain health care settings, such as in a doctor's office or in a pharmacy.

• May not attempt to sell you a plan at an educational event.

• May not offer you free meals at promotional or sales events.

• May not offer you gifts or other promotional items whose value is in excess of $15.

Illinois seniors and people with disabilities who want to find out if they are eligible for the Illinois Cares Rx program, who want to enroll in it, who need assistance with Medicare Part D enrollment or who would like to find the nearest SHIP office should call the Illinois Department on Aging's Senior HelpLine at 1-800-252-8966 (888-206-1327 TTY), call the Senior Health Insurance Program at 1-800-548-9034 or visit http://www.illinoiscaresrx.com/.

[Text from file received from the Illinois Office of Communication and Information]