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 The leading web portal for pharmacy resources, news, education and careers April 20, 2019
Pharmacy Choice - Pharmaceutical News - Program offering refund for those in Part D coverage gap; Covering; The Bases - April 20, 2019

Pharmacy News Article

 2/10/19 - Program offering refund for those in Part D coverage gap; Covering; The Bases

I have the Senior Prescription Drug Assistance Program that pays $40 per month toward my Part D drug plan's premium. I heard that SPDAP will also help me with the costs of my medicines that I incurred when I entered the Medicare Part D doughnut hole. Can you provide more information?

SPDAP is offering a refund (up to $1,700) to qualifying people who entered the Medicare Part D prescription coverage gap (a.k.a. Part D doughnut hole). The refund is for gap costs incurred in 2018. Here is how it works.

First, you must have been enrolled in SPDAP for 2018. Secondly, you must have entered the Medicare Part D coverage gap in 2018. Thirdly, you were not receiving assistance under the federal Part D Extra Help program for the entire calendar year of 2018.

To apply for the SPDAP coverage gap reimbursement, you will need your December 2018 monthly prescription drug summary statement. If you cannot find, or were not issued, a December 2018 monthly prescription drug summary statement, please call your 2018 Part D drug plan and ask them for a 2018 summary statement.

You will send the Part D summary statement to SPDAP, Pool Administrators Inc., 628 Hebron Ave, Suite 502, Glastonbury, CT 06033. You must send your 2018 Part D summary statement to SPDAP by May 31 to access this refund.

If you have any questions, you will want to call SPDAP at 1-800-551-5995.

I am working and my employer offers a health savings account coupled with a high-deductible health plan. I am turning 65 next month. I spoke with my employer and, since they are a large employer, I can remain on my employer's insurance.

However, they warned me against enrolling into Medicare Part A or Part B since there are tax implications. Could you explain?

You describe a very precise situation: A person turning 65 who is actively employed and the employer offers a health savings account coupled with a high-deductible health plan. HSAs allow tax-free contributions and tax-free distributions for qualified health expenses. Under such circumstances, if a person enrolls into either Medicare Part A or Part B, they are no longer eligible to contribute, tax-free, into their HSA.

If you plan on continuing to work and contribute to your employer's HSA, you would want to consider delaying your enrollment into Medicare parts A and B. You would have a special enrollment for Medicare parts A and B based on the fact you have been actively employed and carried your employer's insurance. Under the special enrollment rules, you could time your enrollment into Medicare parts A and B to better match needs.

Please keep in mind your timing for collecting your Social Security check. If you are 65 and elect to draw a Social Security check, you will be automatically enrolled into Medicare Part A. If you elect your Social Security check and you are over age 65 and 6 months, Social Security will make your Medicare Part A enrollment retroactive six months.

Once drawing a Social Security check, you cannot decline Medicare Part A. Enrollment into Part A makes you ineligible for tax-free contributions and you would be penalized for any tax-free contributions you made while enrolled into Part A (even if involuntarily enrolled retroactively).

This discussion is very intricate. You are best advised to continue to discuss this matter with your human resource office, your tax adviser and Social Security. Your SHIP office can provide basic guidance on this topic. SHIP can be reached by calling 410-222-4257.

Amy Rubino is the director of the Senior Health Insurance Assistance Program and the Senior Medicare Patrol for the Anne Arundel County Department of Aging and Disabilities. You may contact either program at 410-222-4257 or ship-program@aacounty.org.

Credit: Amy Rubino - Amy Rubino is the director of the Senior Health Insurance Assistance Program and the Senior Medicare Patrol for the Anne Arundel County Department of Aging and Disabilities. You may contact either program at 410-222-4257 or ship-program@aacounty.org.



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