Medicare Part D helps make medication costs easier and more predictable. We review your prescriptions, compare plans, and ensure you’re covered for the medications you rely on, helping you avoid extra costs and choose coverage that fits your daily routine.
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Medicare Part D is a federal program designed to help cover the cost of prescription drugs for seniors. It's an optional plan designed specifically for prescription medications offered to individuals who are eligible for Medicare, and it works with the following Medicare plans:
Prescription coverage is an important part of your overall healthcare. Medicare Part D plans help you manage medication costs, but the details can be confusing at first. These FAQs explain how Part D works and what to consider when enrolling.
Part D is optional prescription drug coverage offered through private insurance companies approved by Medicare. It helps pay for both generic and brand-name medications, reducing your out-of-pocket costs.
Yes — it’s generally wise to enroll when you’re first eligible. Waiting could mean paying a late-enrollment penalty later, even if you don’t currently take prescriptions.
Each plan has a formulary — a list of covered drugs — organized by cost tiers. Before enrolling, review the formulary or ask your advisor to confirm your specific prescriptions are included.
Yes. You can switch plans during the Annual Election Period (October 15 – December 7) or if you qualify for a Special Enrollment Period due to certain life events.
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Selecting the right Part D plan involves several key considerations:
Costs: Assess the costs associated with each plan, including premiums, deductibles, coinsurance, and coverage gap.
Coverage of Medications: Review each plan’s list of covered drugs, known as the formulary. Formularies are organized into tiers that dictate how much you pay. Ensure that your current medications are covered and check for any restrictions, such as prior authorization.
Pharmacy Network: Verify that your preferred pharmacies are included in the plan’s network. Additionally, some plans offer better savings if you use certain pharmacies.
Annual Enrollment Period (AEP): Every year from October 15th to December 7th, you can make changes to your Medicare prescription drug plan. This period is crucial for reviewing and adjusting your coverage based on your current medication needs.
Initial Enrollment Period (IEP): This is the seven-month window around your 65th birthday when you first become eligible for Medicare. It starts three months before your 65th birthday, includes your birthday month, and extends three months after.
Open Enrollment Period for Medicare Advantage Plans (OEP): If you’re enrolled in a Medicare Advantage plan, you can switch to a different plan or return to Original Medicare, with the opportunity to join a standalone Part D plan from January 1st to March 31st each year.
Special Enrollment Periods (SEPs): Certain life events, such as moving to a new state or losing creditable drug coverage, may qualify you for a Special Enrollment Period.
Some employer plans offer coverage that’s as good as or better than Medicare Part D. This is called “creditable coverage.” If you have creditable coverage and maintain it, you won’t face a late enrollment penalty if you later decide to enroll in Part D. However, if your employer coverage ends or you retire, you’ll need to enroll in a Part D plan to avoid any gaps in coverage.
You may face a late enrollment penalty if you do not enroll in a Part D plan when first eligible and do not have other creditable coverage. This penalty is calculated based on how long you went without coverage and is added to your premium once you enroll in coverage. It’s important to enroll when first eligible to avoid this additional cost.
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