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About Medicare Part D Prescription Plans
If you're eligible for a Medicare Advantage Plan, you're also eligible for Medicare Part D prescription drug coverage.
You'll find answers to commonly asked questions about Part D below. For additional information about Medicare Part D prescription drug coverage and other Medicare-related issues, visit the official Medicare website.
What is a Part D plan?
All Part D plans are private insurance plans offered by private companies. There are two kinds of Part D plans. Stand-alone Part D plans cover prescription drugs only. Medicare Advantage plus Prescription Drug plans include medical coverage for doctor visits and hospital expenses. They also cover prescription drugs.
How much will it cost?
Some people pay monthly health plan premiums, a yearly deductible and co-pays/co-insurance. If you have limited income and resources, you may qualify for Extra Help. If you qualify for both Medicare and Medicaid at the same time (dual eligible), your premium may be covered. You can apply or get more information by calling Social Security at 1-800-772-1213 (TTY 1-800-325-0778) between 7:00 AM and 7:00 PM Monday through Friday or visiting the Social Security Administration Website.
What drugs are covered?
Each Part D drug plan has its own Prescription Drug List (PDL), List of Covered Drugs, a government-approved list of medications covered by the plan. PDLs vary from plan to plan, but all plans offer you and your doctor a number of choices. Before you commit to a plan, it's a good idea to look at the plan's PDL to make sure that it meets your needs.
Will my Part D plan pay for my medications?
Most people pay some of the cost for each prescription they receive. In some cases, you may be responsible for 100 percent of the payment. Some people pay nothing.
When do I have to sign up?
You can join a Medicare drug plan three months before the month you turn 65, the month you turn 65, and three months after you turn 65 (called your Initial Enrollment Period). Generally, if you are disabled, you can join three months before and three months after your 25th month of disability. The plan will notify you when your coverage begins.
Please keep in mind that if you choose to enroll in a Medicare prescription drug plan after your Initial Enrollment Period ends, you may have to pay a late enrollment penalty fee. If you have a Medicare plan without prescription drug coverage, you will need to decide whether or not you wish to enroll in a Medicare prescription drug plan. A penalty fee may apply if you decide to enroll in a Medicare prescription drug plan after the close of the initial enrollment period.
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