Medicare Part D

Medicare Part D

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Medicare Part D Prescription Drug
Reminders and Warnings

For most GIC Medicare enrollees, the drug coverage you currently have through your GIC health plan is a better value than the new Medicare Drug Plans being offered. Therefore, you should not enroll in a Medicare drug plan.

The GIC mailed to all members a "Creditable Coverage Notice" in November that provides proof that you have comparable or better coverage than Medicare Part D. If you should later enroll in a Medicare drug plan because of changed circumstances, you must show this notice to the Social Security Administration to avoid paying a penalty. The Creditable Coverage Notice will be included in all plan handbooks effective July 1, 2006. Keep this notice with your important papers.

If you are a member of one of our Medicare Advantage plans (Fallon Senior Plan, Harvard Pilgrim First Seniority and Tufts Medicare Preferred), your plan automatically includes Medicare Part D coverage. If you enroll in another Medicare Part D drug plan, the Centers for Medicare and Medicaid Services will automatically disenroll you from your GIC Medicare Advantage health plan, which includes both your medical and your drug coverage. Look before you leap!

If you have limited income and assets, the Social Security Administration offers help for paying for Medicare prescription drug coverage and this may be the one case where signing up for a Medicare Part D plan may work for you. Help is available online at or by phone at 1-800-772-1213.

Download the Creditable Coverage Notice in Acrobat Reader format - mailed to GIC members on November 4, 2005. This will be in a health plan handbooks effective July 1, 2006. The Creditable Coverage Notice provides proof to the Social Security Administration that the enrollee has creditable coverage. Members must show this notice to avoid paying a penalty if they later enroll in a Medicare drug plan.

Download the information that follows, which was mailed to Medicare Retirees on September 6, 2005, in Acrobat Reader format

In the coming months you will receive information from various health plans and other organizations about the new Medicare prescription drug benefit known as Medicare Part D. Medicare Part D is generally meant for people who do not have drug coverage from their former employer or through other means.

As a GIC insured, you already have comprehensive drug coverage through your GIC health plan. Therefore, you do not need additional prescription drug coverage. Most of our Medicare-eligible insureds should not sign up for a Medicare Part D drug plan.

However, for some insureds with very limited funds, there may be some benefit to enrolling in a Medicare Part D drug plan. The information below will help you determine whether you should consider joining one of these plans. Again, most insureds will not need to do anything and should not sign up for Part D drug coverage.

Because this is a new and complicated benefit, the GIC will try to keep you informed about what you need to know about Medicare Part D, and about which options are best for you. So, pay particular attention to the GIC’s upcoming articles on Medicare Part D in our quarterly newsletter, For Your Benefit, and be watching for future GIC mailings on this important subject.

Medicare-eligible retirees with assets and income that meet the following thresholds are eligible for Medicare Part D prescription drug subsidy from the federal government. If you meet both the assets and income thresholds in the chart below, you may benefit by enrolling in a Medicare Part D drug plan. For further information, contact the federal government’s Center for Medicare and Medicaid Services (CMS) at 1-800-MEDICARE or 1-800-633-4227.

In determining your assets, the federal government will not count your home (primary residence), your vehicle(s), and your personal possessions.

Assets that will count include:
• Real estate (other than your primary residence)
• Bank accounts, including checking, savings and certificates of deposit
• Stocks and bonds, including US Savings Bonds
• Mutual funds
• Individual retirement accounts (IRAs)
• Cash

Listed below are the groupings that Medicare will use to determine whether you are eligible for a
prescription drug subsidy.

Retirees in Medicare Group 1 will receive the greatest benefit, and retirees in Medicare Group 4 will receive the smallest benefit. Remember to check with CMS if you meet these assets and income limits. The chart below is intended as a guide to help you determine whether you qualify for financial assistance from the federal government. Contact the Center for Medicare and Medicaid Services at 1-800-633-4227 for additional information.

Medicare Category	Retiree Assets Limit		Retiree Annual Income Limit (e.g., pension, Social Security, etc.)
	Single Person	Married Couple	Single Person	Married Couple
Group 1*	Not Applicable	Not Applicable	Less than $9,570	Less than $12,830
Group 2	Less than $7,000	Less than $12,000	Less than $12,920	Less than $17,321
Group 3	Less than $11,500	Less than $23,000	Less than $12,920	Less than $17,321
Group 4	Less than $11,500	Less than $23,000	Less than $14,355	Less than $19,245

* Medicare Group 1 includes retirees who are enrolled in Medicaid — known as MassHealth in Massachusetts — and Medicare.
Guidelines for Determining Eligibility for Federal Drug Subsidy