Marci's Medicare Answers

Dear Marci, Every year my Medicare Part B premium is higher. What will it be this year? - Scott Dear Scott, In 2007, most people's Medicare Part B premium will be $93.50. For the first time ever, the Part B premium is based on income. If your annual income is above $80,000 ($160,000 for couples) your Part B premium will be higher than $93.50. To find out what you will pay, call Social Security at 1-800-772-1213 or check www.medicarerights.org/newmedicarecosts.html. Dear Marci, I plan to spend the winter in Florida. Will Medicare cover my health care there? - Mary Dear Mary, It depends on which Medicare health plan you have. If you have Original Medicare, you will be covered to go to any doctor or hospital in any state or U.S. territory. If you are enrolled in a Medicare private health plan, like an HMO or PPO, you have to follow your plan's rules. These private plans generally restrict you to seeing doctors and hospitals in your plan's network. You will pay more-sometimes the full cost-for non-emergency care received outside of your private plan's network. Call your plan and ask what the rules are for out-of-network care. If you want to switch to Original Medicare, you can do so from November 15 to December 31 every year. You can also change your choice of health coverage between January 1 and March 31 (but you can not choose to add or drop Medicare drug coverage-Part D-during this period). - Marci Dear Marci, I signed up for a new Medicare drug plan this year. Last year some friends had trouble filling their prescriptions, and I am worried about what I will do if this happens to me. - Eddy Dear Eddy, Medicare drug plans are required to offer their new members a "transition policy." You can use this to immediately fill at least one 30-day supply of every prescription you were taking before your new drug coverage began. You can tell your pharmacist to fill the prescription using your drug plan's "transition" or "temporary" first-fill policy, regardless of whether the drug plan covers the prescription or has placed restrictions on it. While you are getting this supply, ask your doctor to either switch you to a covered drug or to ask your plan for an "exception" to cover the drug you need. You can only use your drug plan's transition policy during the first 90 days after joining. If you have trouble getting your prescriptions filled, call the Medicare Rights Center's Medicare Drug Appeals hotline at 888-466-9050. Marci's Medicare Answers is a service of the Medicare Rights Center (www.medicarerights.org), the nation's largest independent source of information and assistance for people with Medicare. To subscribe to "Dear Marci," MRC's free educational e-newsletter, simply e-mail dearmarci@medicarerights.org. Medicare Rights Center www.medicarerights.org