Medicare Part D Plans

Getting Medicare Drug Coverage

Medicare offers prescription drug coverage to everyone with Medicare. Electing not to get Medicare drug coverage when you are first eligible may result in a late enrollment penalty, unless you have an alternative form of prescription drug coverage. To avoid this penalty, enroll in a Prescription Drug Plan now by getting matched with a top rated provider.

The only way to receive Medicare drug coverage is through enrolling in a plan run by an approved Medicare provider. Drug coverage and costs will vary depending on the plan and company.

Part D covers only prescription drugs and will add prescription drug coverage to original Medicare, as well as some Medical Cost Plans, Medicare Private Fee-for-Service Plans and Medicare Savings Account Plans

If you are enrolled in a Medicare Advantage Plan that provides prescription drug coverage and you enroll in Part D, your Part C will disenroll you and you will go back to Original Medicare, with Part D coverage.

Enrolling in A Drug Plan

Once your have chosen a specific insurance carrier and plan, there are several ways to make your selection:

  • Enroll on the Medicare Plan Finder or on the plan’s website
  • Complete a paper enrollment form
  • Call the insurance carrier

When you join a Medicare drug plan, you will receive your Medicare number and the date your coverage starts. This information can be located on your Medicare card.

There are specific times when you can sign up for these plans for make changes to your existing coverage.

New Enrollees

If you are turning 65 and are new to Medicare, you may enroll at any during the month you turn 65, as well as the three months prior or the three months following.

If you enroll prior to turns 65, coverage will begin the first day of the month you turn 65. If you join the month you turn 65 or three months following, coverage will begin the first day of the month following the month you enrolled.

Currently Enrolled

You do not need to re-enroll in Medicare each year. Your coverage will continue from year to year if you do not elect to make changes to it. However, each year you will have a change to review your coverage and make changes.

There are two =enrollment periods each year:

  1. Open Enrollment: October 15th to December 7th
  2. Medicare Advantage Disenrollment: January 1st to February 14th

During open enrollment periods there is no penalty to join a Medicare Prescription Drug Plan or switch from one Medicare drug plan to another Medicare drug plan

During Medicare Advantage Disenrollment there is no penalty to Switch from a Medicare Advantage Plan to a Prescription Drug Plan or

Drug Plan Coverage

Each Medicare Prescription Drug Plan has its own list of covered drugs (formulary). Plans typically place different drugs in tiers. Each tier of drugs has a difference cost range.

Drug tiers are typically set by insurance carriers annually. However, drugs can change tiers within a year, if insurance carriers follow guidelines set by Medicare. If a drug you are taking changes price mid year, your plan must provide written notice to you at least 60 days in advance of the date the change becomes effective. At this time you may provide the written notice to request a 60 day supply of the drug under the same plan rules as before the change.

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Medicare Supplement

Medicare Supplement plans (Medigap) cover “gaps” in Original Medicare (Parts A & B). Each state approves a set of coverage options.

Medicare Advantage (Part C)

Medicare Advantage Plan work like an HMO or PPO health plans and help to limit out of pocket expenses. Plans may also include prescription drug coverage.

Medicare Part D Plans

Medicare Part D Plans have a list of covered medications called a Formulary. Medications on the Formulary will be covered as part of Part D.