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APPENDIX G - PROCEDURES FOR RESOLVING MEDICARE PART D CONCERNS

Many DC Medicaid and QMB recipients have questions about the new Medicare Part D program. The questions and answers below should help you provide assistance to these customers. To search for a particular word or phrase (for example, “Veteran” or “Kaiser”) just hit CTRL-F and search for that term. ESA’s most important role: reassure customers with Medicare that they will still be able to get their prescriptions under the new program. These customers just need to pick a Part D drug plan. To get help choosing a plan, customers can call (202) 739-0668 or 1(800) MEDICARE (1-800-633-4227). For customers in distress: please write down the customer’s information and email it to medicaid@dc.gov. We will reach out to the customer and try to help.

Frequently Asked Questions Should you enroll in Part D if you have DC Medicaid? ("Should I enroll in Part D if I have a blue or white DC Medicaid card?") YES! Starting January 1, 2006, you must get your drugs through a Part D drug plan if you have Medicare. Even if you have both DC Medicaid and Medicare, you will have to use your red, white, and blue Medicare card to get most of your drugs. You can pick a plan by calling (202) 739-0668 or 1(800) MEDICARE (1(800) 633-4227). If you pick a plan before New Year's, then you will get your drugs from this new plan. You will still have drug coverage after January 1, 2006. What if Medicare has "auto-enrolled" you into a Part D drug plan? Medicare recently sent letters to customers who also have DC Medicaid. These letters explain the “automatic enrollment” process. If you do not pick a Part D drug plan before January 1, 2006, then Medicare will randomly assign you to a drug plan. However, you can change your plan. To find out if you should keep this plan or switch to another plan, call (202) 739-0668 or 1(800) MEDICARE 1(800) 633-4227. What drug plan is best for you? Each drug plan covers different drugs. You need to pick a plan that covers the drugs that you take. To find out which drug plan is right for you, call (202) 739-0668 or 1(800) MEDICARE (1(800) 633-4227). There are 15 special drug plans for people who have DC Medicaid or who get extra help for Part D. (See Question #5 below.) If you pick one of these 15 special plans, then you will not have to pay a monthly premium for Part D. Also, these special plans will have no deductibles. The ESA Fact Sheet on Part D lists these 15 plans and their contact information. Note: ESA staff should (a) offer to transfer the call and (b) counsel customer to call back to ESA if he or she does not get any assistance. When can you sign up? You should pick a Part D plan between November 15 and December 31, 2005. If you pick a plan before New Year's, then you will be able to get your drugs starting on January 1, 2006.