| Medicare
Part D – Prescription Coverage
Medicare Part
D is a federal program to subsidize the costs of prescription drugs for Medicare
beneficiaries in the United States. This benefit is administered private
insurance companies that are then reimbursed by the Centers for Medicare and
Medicaid Services (CMS). You
can obtain Part D prescription drug coverage in two ways: by purchasing a Prescription
Drug Plan (PDP) for drug coverage only or you can join a Medicare
Advantage (MA) plan that covers both medical services and prescription drugs.
Those who decide to enroll in the Medicare Part D PDP program can chose from
a list of hundreds, and in some areas thousands, of options for Part D coverage. It
is important to note that each insurance company maintains its own list of what
it considers to be "covered" medications. Since these lists
can vary dramatically from one company to another, it is critically important
for anyone purchasing this type of coverage to make sure that they chose a plan
that meets their needs. By
far the best, and easiest, way to compare Part D coverage from all of the plans
in your area is by visiting the CMS
Part D web site. This site will allow you to enter all of the medications
you take, and will quickly show you a price quote and coverage comparison for
all of the plans available in your area. There is no better way to find
the best Part D coverage for your personal situation.
When Can You Sign
Up for Part D Coverage - Enrollment Periods You
can enroll for Part D Prescription Drug Coverage when you become eligible at
age 65, or during the open enrollment period as described below.
1.
Annual Open Enrollment
The Annual
Coordinated Election Period occurs November 15 through December 31
of every year. During this time, you may enroll in or change Medicare
Prescription Drug Plans. Coverage will be effective January 1 of the next
year. - You
are entitled to Medicare Part A or are enrolled in Part B.
- Your
permanent residence is within the United States.
- You
must continue to pay your Medicare Part B premium, if not otherwise paid for
under Medicaid or by another third-party.
- You
are not enrolled or do not plan to stay enrolled in another Medicare Prescription
Drug Plan.
You may enroll in only one Medicare Prescription Drug Plan at a time and may
not be enrolled in a Medicare Advantage Plan at the same time. If you
are enrolled in a Medicare Advantage Plan, you’ll be disenrolled if you join
a Medicare Part D prescription drug plan.
If you have a Medicare Supplement plan, you may be able to switch to a different
plan without prescription drug coverage.
2. Initial Enrollment
Period
The Initial
Enrollment Period is a seven-month period that includes the month during which
you first become eligible (at age 65 or if you qualify due to disability or
end-stage rental disease) plus the three months before and the three months
after the month in which you become eligible.
If you do not enroll during your seven-month Initial Enrolment period, you will
have an opportunity to join a prescription drug plan once a year from November
15 through December 31. However, delaying enrollment after the Initial
Enrollment Period may result in a late enrollment penalty.
The late penalty is currently 1% of the national average monthly premium for
each month you were eligible but were not enrolled in a Medicare Prescription
Drug Plan. The penalty will be added to your premium for as long as you
are enrolled in Medicare's prescription drug coverage.
You can delay enrollment in Medicare's prescription drug coverage without paying
a penalty if you have creditable coverage as an individual or through an employer
group policy. Creditable coverage is a drug benefit of equal or greater
value than Medicare's standard prescription drug coverage.
3. Special Enrollment
Period
A Special Enrollment
Period is available in certain situations, such as if you permanently move outside
the service area. In this case, you may enroll in or change Medicare Prescription
Drug Plans.
Quotes and How to
Apply
The best way
to apply for Part D coverage is by visiting the CMS
Part D web site. If you still have any questions after reviewing this
site, just contact one of our friendly MediGap
Advisors at 866-323-1441
or e-mails us at info@MediGapAdvisors.com and
we will be happy to assist.
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