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Wisconsin SeniorCare Fact Sheet
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PDF (24 KB)
SeniorCare and Medicare Part D
SeniorCare is Creditable Coverage
The Wisconsin SeniorCare prescription drug assistance program is considered
“creditable coverage.” This means SeniorCare is as good as the standard Medicare
Part D plan.
If you are enrolled in SeniorCare, you can keep SeniorCare and not pay extra
if you decide to enroll with Medicare Part D at a later date. If you let your
SeniorCare end and do not enroll in a Medicare Part D plan, you may have to pay
more to enroll in Medicare Part D if you decide to enroll at a later date.
If you go without creditable prescription drug coverage for 63 days or
longer, your monthly premium for Medicare Part D will go up at least one percent
for each month you did not have coverage.
For example, if you go nine months without coverage, your premium will
always be at least 9% higher than what most other people pay.
Medicare Part D Enrollment
If you do not enroll in a Medicare Part D plan when you are eligible, you
will still be able to enroll, however, you will have to wait until the next
enrollment period which is November 15 through December 31.
If you enroll in a Medicare Part D plan, your coverage will begin about a
month after you enroll. If you need help paying for your prescription drugs, and
you are currently enrolled in SeniorCare, you may want to remain on SeniorCare
at least until your Medicare Part D coverage begins.
Medicare Part D Low Income Subsidy
There is extra help for people with limited income and resources. Almost 1 in
3 people with Medicare will qualify for extra help and Medicare will pay for
almost all of their prescription drug costs. You can apply or get more
information about the extra help by calling Social Security at 1-800-772-1213
(TTY 1-800-325-0778) or visiting
www.socialsecurity.gov.
Applying for the extra help and enrolling in a Medicare Part D plan are two
different processes. Once you are determined eligible for the extra help, you
will have to pick a Primary Drug Plan (PDP) and enroll in that PDP.
Out-Of-Pocket Cost for SeniorCare and Medicare Part D
Out-of-pocket costs for both SeniorCare and Medicare Part D depend on the
amount of income you have. People with higher income can expect to have higher
out-of-pocket costs. The out-of-pocket costs for Medicare Part D also depend on
whether you are eligible for extra help and in which plan you enroll. Some plans
have higher premiums than others.
People with lower income and assets who choose to enroll in a Medicare Part D
plan may have better coverage if they qualify for extra help and the drugs they
need are covered under the plan they select.
Important Information
We urge you to carefully examine the benefits and coverage under any Medicare
Part D plan before you enroll. For help determining which prescription drug plan
is best for you, you can contact your County Department of Aging and ask for a
benefits specialist.
For More Information
There are many resources available to answer questions about SeniorCare and
Medicare Part D. These include:
- SeniorCare Hotline at 1-800-657-2038 for questions about SeniorCare,
- Prescription Drug Hotline at 1-866-456-8211, for questions about Medicare
Part D, or
- Benefits Specialist at your County Department on Aging.
The Department of Health and Family Services is an equal opportunity employer
and service provider. If you have a disability and need to access this
information in an alternate format, or need it translated to another language,
please contact (608) 266-3356 or 1-888-701-1251 TTY. All translation services
are free of charge.
For civil rights questions, call (608) 266-9372 or 1-888-701-1251 (TTY).
PHC 10074 (08/06)
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Date Last Revised:
July 07, 2008
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