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NC Department of Health and Human Services Division of Mental Health, Developmental Disabilities, and Substance Abuse Services

Medicare Prescription Drug Plan (Part D)

This website is being devoted to helping you understand the new Medicare Prescription Drug Benefit and what consumers need to do to apply for help with costs and to enroll for a Prescription Drug Plan (PDP). It includes links to informative websites with important information pertinent to the new program and that will benefit consumers of mental health, developmental disabilities and substance abuse services. This site will be updated on an ongoing basis as new information becomes available.

In 2003, an act was passed that added a prescription drug benefit to Medicare. Individuals who are eligible for Medicare can sign up for a private drug plan and get help with prescription drug coverage. While some of these plans will cost a premium and co-pays, many individuals can apply and receive help with these drug costs. Individuals who are eligible for both Medicare and Medicaid benefits will automatically qualify for this assistance with costs.

What is the Medicare Prescription Drug Plan?

The new drug benefit will be provided by private prescription drug plans (PDPs) that offer drug-only coverage, or through Medicare Advantage Plans that offer both prescription drug and health care coverage (MA-PD plans). Plans must offer a standard drug benefit, including many, but not all, of the same drugs that are approved under the Medicaid program. Plans will have utilization tools, prior authorizations and limits, may have preferred tiers and will have network pharmacies. Beneficiaries will pay monthly premiums, deductibles, coinsurance and co-pays. The prescription drug benefit begins on January 1, 2006. For more information

What do People Receiving Medicare Need to Do?

There are two steps for consumers to prepare for the transition to Medicare Part D Prescription Drug Coverage:

1. Apply for help with Medicare Prescription Drug Plan Costs. If the consumer is eligible for both Medicaid and Medicare he/she is automatically qualified and doesn't not need to apply.

2. Enroll in a Medicare Prescription Drug Plan (PDP)

How can a Clinician, Psychiatrist or Case Manager help Consumers?

Attend Training -- The Department of Insurance SHIIP program is holding training events this fall to help you understand how to help consumers with enrollment.

Contact your local Senior Health Insurance Information Volunteers. These volunteers are trained to council consumers on Medicare Part D issues.

Help consumers apply for help with Medicare Prescription drug costs.

Prescription Drug Coverage Outreach Materials to help you inform consumers.

Information on How to Implement Medicare Part D in Your Agency

Where can Consumers Find Information Written Specifically for them?

See here for links to sites.

For Assistance with the Following Languages, Please call the Toll Free Numbers:

Chinese 1-800-582-4218
Korean 1-800-582-4259
Vietnamese 1-800-582-4336

What Plans are Approved for Medicare Part D in North Carolina?

See here for approved plan list.

More Information

Information for Consumers and Advocates

9/16/05 Memo from DMH/DD/SAS Director

11/1/05 Memo from DMH/DD/SAS Director

11/18/05 Memo from DMH/DD/SAS Director

12/16/05 Memo from DMH/DD/SAS Director

Medicare Modernization Act Prescription Drug Benefit Current Publications

Find out more about Medicare Prescription Drug Coverage. This site includes articles, public service announcements, and training material for use by providers.

Para nuestros clientes que desean leer información respecto Medicare Parte D en español:


Application for Help with Medicare Prescriptions Drug Plan Costs:

Stand Alone Prescription Drug Plan Organizations Available in NC:

Information Specific to State Psychiatric Hospitals & State and Local ICF/MRs:

Information Specific to People who are Eligible for both Medicare and Medicaid:

Medicare will Enroll You in a Plan Automatically if you don't choose. How to find out which plan. Ready NC Connect NC