Questions and answers for retired STATE participants covered under the State's Group Health Insurance Program

What is Medicare Part D?

It is a new prescription drug benefit program created by the federal government. Enrollment in Medicare Part D coverage through approved prescription drug plans begins November 15, 2005, for coverage effective January 1, 2006.

I have prescription drug coverage through the state's group health insurance program. Should I enroll in a Medicare Part D prescription drug plan when I become eligible?

We recommend against it. Keep in mind you are already paying for and receiving comprehensive prescription drug coverage through the state's group health insurance program. Your current drug coverage, administered through Navitus Health Solutions, is "creditable coverage" in comparison to the Medicare Part D prescription drug benefit. This will allow you to defer enrollment in Part D without penalty. Nevertheless, you should carefully consider all options before making any kind of enrollment decision. Participation in Medicare Part D is voluntary. If you would like to maintain your current level of prescription drug benefits under our program, it is not necessary to enroll in Medicare Part D at this time.

How will this change affect me?

The impact on retirees eligible for or enrolled in Medicare is expected to be minimal, and virtually seamless. If you are not lower income and thus not eligible for extra financial help from Medicare, and the drugs you take now are typically covered by your retiree prescription drug coverage, you will generally pay less out of pocket costs for drugs if you do not join a Medicare drug plan. And best of all, you can keep your coverage without doing anything new. No paperwork needs to be filled out.

Will my state health insurance premium go down if I enroll in a Medicare Part D prescription drug plan?

No. The 2006 health insurance premium printed in the 2006 It's Your Choice booklet (ET-2108 rev. 10/05) includes both medical and prescription drug coverage and is already reduced to account for the Medicare drug subsidy. If you enroll in a Medicare prescription drug plan, you will continue to pay the same premium in addition to paying the Part D premium for the Medicare prescription drug plan you choose. You may also have to manually submit claims to Navitus if you choose to enroll in a Medicare Part D plan.

Will Medicare penalize me if I do not enroll in Medicare Part D?

No. Because coverage through the State of Wisconsin Group Health Insurance Program is, on average, as good as if not better than the standard Medicare prescription drug coverage, you will not have to pay a penalty if you enroll later. The certificate of creditable coverage is located in your 2006 It's Your Choice booklet, pages B-10 and B-11.

Where can I get more information about how my pharmacy benefits are affected by the Medicare Part D program?

Information is available in the 2006 It's Your Choice booklet, in the September edition of the It's Your Benefit Newsletter, and on the Department Internet site. The Department also mailed letters to state retirees in September explaining how pharmacy benefits are affected by Medicare Part D.

Other resources for you include the following:

• Certificate of Creditable Coverage for Medicare Part D
• Center for Medicare and Medicaid Services Fact Sheet
• Medicare D Letter Sent to Annuitants September 28, 2005
• Wisconsin Medicare D Resource Center