RCPA - Rehabilitation and Community Providers Association


Medicare Drug Plans Approved for Pennsylvania
September 27, 2005

On September 23 the Centers for Medicare and Medicaid Services (CMS) announced the plans that were approved to provide prescription drug coverage for Medicare beneficiaries in Pennsylvania. There are 19 Prescription Drug Plans (PDPs) approved, one of which will have a premium of less than $20 per month. There are 16 Medicare Advantage Prescription Drug Plans (MA-PDs) that will provide both health care and prescription drug coverage, one of which is a preferred provider organization. Fourteen of the PDPs were approved to auto-enroll Medicare beneficiaries, the option available to dual eligibles. Information about the plans approved in Pennsylvania is available on the CMS web site (www.cms.hhs.gov/map/map.asp#PA).

Marketing of these plans begins October 1. Comparative information will be available on the Medicare consumer web site (www.medicare.gov) beginning in mid-October. Information will also be available through the Medicare toll free number (800-633-4227). More local assistance is available in Pennsylvania through the Apprise Program (800-783-7067 or 866-286-3636). Please access the web site for information on local meetings to educate providers and consumers about the Medicare Prescription Drug Benefit that are presented through the Department of Aging and the Apprise Program (pda-apprise.org/meetings/index.php) or contact the Apprise Program to schedule additional presentations in your area. The Office of Mental Health and Substance Abuse Services is presenting four programs for providers on September 26 at Temple University in Philadelphia and the Woodlands Inn and Resort in Wilkes-Barre, September 27 at Temple University in Harrisburg, and September 28 at the Union Trust Bldg #2 at Mellon Center in Pittsburgh. Information on these programs is available on the PCPA web site.

The Departments of Aging and Insurance encourage Medicare beneficiaries to be aware of potential scams as PDPs and MA-PDs are marketed. They suggest that the following be considered by beneficiaries as they make decisions about prescription drug coverage:

  • No one can enroll in any Medicare prescription drug plan before November 15. If someone solicits enrollment prior to this dat, it could be a scam.
  • Never offer personal financial information, such as bank account numbers, to solicitors or telemarketers.
  • Do not pay with cash. Always write a check.
  • Call APPRISE for free, unbiased advice on plan options.
  • Contact the Insurance Department at 717-787-2317 or through the web site (www.insurance.state.pa.us) to confirm that the person and/or business that is soliciting enrollment is a licensed insurance professional.

Contact Betty Simmonds at PCPA with questions.

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