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Important Notice From South Georgia Health System About Your Prescription Drug Coverage And Medicare


Please read this notice carefully and keep it where you can find it.  This notice has information about your current prescription drug coverage with South Georgia Health System and about your options under Medicare’s prescription drug coverage.  This information can help you decide whether or not you want to join a Medicare drug plan.  Information about where you can get help to make decisions about hour prescription drug coverage is at the end of this notice.

   Medicare prescription drug coverage became available in 2006 to everyone with Medicare.  You can get this coverage if you join a Medicare Prescription Drug Plan or join a Medicare Advantage Plan (like an HMO or PPO) that standard level of coverage set by Medicare.  Some plans may also offer more coverage for a higher monthly premium. 

    South Georgia Health System has determined that the prescription drug coverage offered by the South Georgia Health System plan is, on average for all plan participants, NOT expected to pay out as much as standard Medicare  Non-Creditable Coverage.  This is important because, most likely, you will get more help with your drug costs if you join a Medicare drug plan, than if you only have prescription drug coverage from the South Georgia Health System Plan.  This also is important because it may mean that you may pay a higher premium (a penalty) if you do not join a Medicare drug plan when you first become eligible.

You can keep your current coverage from the South Georgia Health System plan.  However, because your coverage is non-creditable, you have decisions to make about Medicare prescription drug coverage that may affect how much you pay for that coverage, depending on if and when you join a drug plan.  When you make your decision, you should compare your current coverage, including what drugs are covered, with the coverage and cost of the plans offering Medicare prescription drug coverage in your area.  Read this notice carefully - it explains your options.

When Can You Join A Medicare Drug Plan?

You can join a Medicare drug plan when you first become eligible for Medicare and each year from October 15th through December 7th.

When Will You Pay a Higher Premium (Penalty) To Join A Medicare Drug Plan?

Since the coverage under South Georgia Health System plan is not creditable, depending on how long you go without creditable prescription drug coverage, you may pay a penalty to join a Medicare drug plan.  Starting with the end of the last month that you were first eligible to join a Medicare drug plan but didn’t join, if you go 63 continuous days or longer without prescription drug coverage that’s creditable, your monthly premium may go up by at least 1% of the Medicare base beneficiary premium per month for every month that you did not have that coverage.  For example, if you go nineteen months without creditable coverage, your premium may consistently be at least 19% higher than the Medicare base beneficiary premium.  You may have to pay this higher premium (penalty) as long as you have Medicare prescription drug coverage.  In addition, you may have to wait until the following October to join. 

What Happens To Your Current Coverage If You Decide to Join A Medicare Drug Plan?

If you decide to join a Medicare drug plan, your current South Georgia Health System coverage will not be affected. 

You have several options related to Medicare Part D and the coverage you have under the South Georgia Health System plan:

You may retain your existing coverage under the South Georgia Health                         System plan and choose not to enroll in a part D plan (But see the section above on higher premiums). 

You may enroll in a Part D plan as a supplement to the South Georgia Health System plan, however, this plan will not coordinate with Part D coverage.

Your current coverage pays for other health expenses in addition to prescription drugs.  If you enroll in a Medicare prescription drug plan, you and your eligible dependents will still be eligible to receive all of your current health benefits.

However, if you do decide to join a Medicare drug plan and drop your current South Georgia Health System coverage, be aware that you and your dependents will not be able to get this coverage back unless the South Georgia Health System plan allows late enrollment or has an annual open enrollment period that permits such plan enrollment.

For More Information About This Notice Or Your Current Prescription Drug Coverage...

Contact the person listed below for further information.  NOTE:  You’ll get this notice each year.  You will also get it before the next period you can join a Medicare drug plan and if this coverage through South Georgia Health System changes.  You also may request a  copy of this notice at any time. 

South Georgia Health System

Human Resources

2501 N. Patterson Street

Valdosta, GA 31602


For More Information About Your Options Under Medicare Prescription Drug Coverage...

More detailed information about Medicare Plans that offer prescription drug coverage is in the “Medicare & You” handbook.  You’ll get a copy of the handbook in the mail every year from Medicare.  You may also be contacted directly by Medicare drug plans.  For more information about Medicare prescription drug coverage:

    Visit www.medicare.gov

    Call your State Health Insurance Assistance Program (see the inside back cover of your copy of the “medicare & You” handbook for their telephone number) for personalized help

    Call 1-800-MEDICARE (1-800-633-4227).  TTY users should call 1-877-486-2048.

If you have limited income and resources, extra help paying for Medicare prescription drug coverage is available.  For information about this extra help, visit Social Security on the web at www.socialsecurity.gov, or call them at 1-800-772-1213 (TTY 1-800-325-0778).