Date: November 14, 2007
For more information contact: Mikaela Reck, Public Information Officer, (608) 267-9336 or mikaela.reck@wisconsin.gov

12 things to know before signing up for Medicare Part D

Madison, WI—Many Wisconsin senior citizens will be receiving phone calls, emails and/or information in their mailboxes regarding the annual open enrollment period for Medicare Part D prescription drug plans (PDP). If you are considering a Medicare Part D PDP, you need to examine your prescription drug needs and the costs and benefits of the various plans.

"We understand there are many different Medicare Part D plans being offered," said Sean Dilweg, Commissioner of Insurance. "It's important for those people who qualify for Medicare to understand a number of things before signing a contract."

Commissioner Dilweg suggests the following list of things all seniors should know before signing up for Medicare Part D:

  1. Participation in the Medicare Part D program is voluntary. If you don't do anything, your existing outpatient prescription drug coverage and Medicare supplement policy will remain the same.
  2. You can continue with the SeniorCare program until you receive notice informing you otherwise. Call SeniorCare at 1-800-658-2038 for further information.
  3. You do not have to enroll in Medicare Part D in order to keep your existing Medicare Part A and Part B coverage.
  4. You do not have to buy any additional insurance products to be eligible to enroll in Medicare Part D and all seniors should be wary of any individual who uses a Part D sales pitch to sell other insurance products.
  5. If you enroll in a Medicare Part D PDP, you will receive an amendment to your existing Medicare supplement policy and the amendment will remove all outpatient prescription drug benefits in your Medicare supplement policy.
  6. If you enroll in a Medicare Part D PDP, your Medicare supplement policy will be amended to remove the benefits covering prescription medication for treatment of diabetes, and insulin and supplies associated with the injection of insulin. These benefits will be provided by the Medicare Part D PDP but will be subject to the deductible, coinsurance and co-payments associated with the PDP coverage.
  7. If you change your mind after you have enrolled in a Medicare Part D PDP, you will not be able to reinstate the outpatient prescription drug coverage you have had under your Medicare supplement policy, group retiree health plan.
  8. You will have an open enrollment period from November 15, 2007, to December 31, 2007, to enroll in a Medicare Part D PDP.
  9. You may be subject to enrollment penalties (higher premiums) if you delay enrolling in a Medicare Part D PDP. You will receive annual notice from your Medicare supplement insurer or group retiree plan indicating that your prescription drug coverage is, on average, at least as good as Medicare Part D. This means your coverage is considered creditable drug coverage, and you will not be subject to the penalty.
  10. Medicare Part D PDPs have monthly premiums and may have deductibles and coinsurance and co-payment requirements. Information regarding covered medications, costs, and coverage areas will be available on Medicare's website, http://www.medicare.gov.
  11. You may be eligible for extra help to pay for your Medicare Part D prescription drug expenses and/or premiums based on your income. Information is available by contacting the Social Security Administration at 1-800-772-1213 or www.ssa.gov.
  12. If you want to know how your current coverage will be affected by enrolling in a Medicare Part D PDP, you can talk to an insurance counselor at the Medigap Helpline at: 1-800-242-1060.

Before enrolling in Part D, seniors should review how their current drug coverage will be affected, determine how much their annual out-of-pocket expense for prescription medications will be, determine what the Part D coverage will be annually for premiums, deductibles and co-pays, and determine if they are eligible for a subsidy to cover expenses under Part D.

The Centers for Medicare and Medicaid Services (CMS) has published a listing of the Medicare Part D PDPs that can offer outpatient prescription drug coverage to Wisconsin Medicare beneficiaries. The list of these PDP plans is published in your "Medicare & You 2008" book. Additional information can be found by calling CMS at 1-800-MEDICARE (1-800-633-4227).

A fact sheet titled 12 Things to Know Before Signing Up for Medicare Part D is available on the OCI Web site. OCI publications, such as Medicare Advantage Plans in Wisconsin, and Wisconsin Guide to Health Insurance for People with Medicare, are also available, and can be ordered free from the agency by writing to OCI Publications, P.O. Box 7873, Madison, WI 53707-7873, calling 800-236-8517 or visiting the OCI Web site at oci.wi.gov.


Created by the Legislature in 1871, Wisconsin's Office of the Commissioner of Insurance (OCI) was vested with broad powers to ensure that the insurance industry responsibly and adequately met the insurance needs of Wisconsin citizens. Today, OCI's mission is to lead the way in informing and protecting the public and responding to its insurance needs.