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 by joining 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 choose 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 choose a plan that meets their needs.
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 October 15 through December 7 of every year. During this time, you may enroll in or change Medicare Prescription Drug Plans under the following qualifications:
- 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 October 15 through December 7. 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.
Because of the 1% per month price penalty for delaying purchase of your prescription drug benefit, most people will benefit from signing up for a Part D plan right away, even if you do not currently use prescription drugs. As long as you are just signed up for even the cheapest available plan, you can change to a different plan later without facing this penalty.
If you do not have a Part D plan, you can still benefit by being a smart consumer. Visit our page on How to Pay Less for Prescription Drugs, and learn about a free prescription drug discount card, and how to get your ongoing maintenance medication at wholesale prices via international pharmacies.
If you would like us to provide a quote on Part D prescription coverage, we will be happy to research your options and let you know the best options we can find. Before we are allowed to provide information on these plans, Federal law requires that you fill out the Scope of Appointment Form.
After completing that form, you will be taken to a page where you can give us information on which medications you take, and which pharmacy you use. We will then be able to compare different plans, and let you know your options.
If you have any other questions, just contact one of our friendly advisors at 866-323-1441 or e-mail us at info@MediGapAdvisors.com and we will be happy to assist.
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