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2016 Federal Poverty Level Guidelines (FPL): 2016-2017 LIS Qualifications and Benefits
The 2016 Federal Poverty Level (FPL) Guidelines determine the income level requirements for people applying for the Medicare Part D Low Income Subsidy (LIS) program, also known as the "Extra Help" pro ...

2017 Low-Income Subsidy Benchmark Premium Amounts (includes 2017 - 2006 for comparison)
The Centers for Medicare and Medicaid Services (CMS) released the 2017 low-income premium subsidy amounts (or Benchmark) for Medicare Part D plans on July 29, 2016.  In 2017, ten (10) states wi ...

What does the letter after my Medicare number mean?
We have been getting more questions from people asking what the letters mean in their Medicare Claim Number.  Here is an explanation and chart of the letter meaning provided by the Social Securit ...

Medicare Advantage plan and Medicare Part D prescription drug plan Special Enrollment Periods(SEP)
In certain situations, people with Medicare may be eligible for a Special Enrollment Period (SEP) allowing them to join a Medicare Advantage plan or Medicare Part D prescription drug plan , or switch ...

What is the difference between 2016 Preferred Network Pharmacies and Network Pharmacies?
First, both preferred and non-preferred network pharmacies are included in a Medicare prescription drug plan’s pharmacy network.  However, preferred network pharmacies usually have lower c ...

Does Medicare Cover Vitamin B-12 Injections (Shots)?
In specific cases, Medicare will cover Vitamin B-12 injections (as noted in the Medicare benefits manual). Medicare Benefit Policy Manual Chapter 7 - Home Health Services (Rev. 208, 05-11-15) 4 ...

Roughly a 3% increase in the 2016 Income Related Medicare Adjustment Amounts (IRMAA) for Medicare beneficiaries with higher annual incomes.
Medicare beneficiaries who earn over a certain amount will pay an additional premium for the their Medicare Part B (out-patient coverage) and Medicare Part D prescription drug plan coverage (whether r ...

WellCare Medicare Plan 2015 & 2016 Medicare Pharmacy and Healthcare Provider Search Tools
You can find the 2016 WellCare Medicare Part D (PDP) pharmacy search and Medicare Advantage plan provider search tool at:  https://www.wellcare.com/Find-a-Provider#/Search. You can also start at: ...

Medicaid "Spend Down" and Medicare Part D
People with Medicare who are also eligible for Medicaid because of high medical expenses can get Medicare prescription drug coverage no matter if they are in the Original Medicare Plan or a Medicare A ...

SilverScript Medicare Part D Pharmacy and Formulary Search
Question: What drug stores accept the SilverScript Medicare Part D prescription drug plans? Most Medicare Part D plans are accepted by over 50,000+ pharmacies across the country. However, if you ...

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Q1Group 2017 PDP Analysis: Fewer stand-alone 2017 Medicare Part D prescription drug plan choices
According to the recently released Centers for Medicare and Medicaid Services (CMS) Medicare Part D landscape data, most Medicare beneficiaries across the country will have fewer stand-alone 2017 Medi ...

CMS Press release: Medicare Advantage premiums remain stable in 2017; beneficiaries have saved over $23.5 billion on prescription drugs
The Affordable Care Act has made the Medicare program stronger for seniors and people with disabilities Today, the Centers for Medicare & Medicaid Services (CMS) announced that 2017 Medicar ...

Extra Help Update: The 2016 / 2017 CMS, SSA, and Medicare plan mailings schedule is online
The 2016 / 2017 mailings schedule from the Centers for Medicare and Medicaid Service (CMS), the Social Security Administration (SSA), and Medicare plans mailings schedule is now online and includes th ...

August 2016 Formulary Changes to the Top Medicare Drugs
The August, 2016 Medicare Part D plan formulary (or drug list) data included 82 new drug codes representing 31 different medications. Although this article is about some of the "top Medicare drugs" ...

August 2016 summary of the new medications added to Medicare Part D plan formularies (drug lists)
The August, 2016 Medicare Part D plan formulary data (or drug lists) includes the addition of 82 new National Drug Codes (NDC) to the Medicare Part D program.  These NDCs represent 47 different d ...

2017 Medicare Part D Late-Enrollment Premium Penalties will increase by 4.5%
The average monthly 2017 Medicare Part D base premium used to calculate the late-enrollment penalty will increase to $35.63, a 4.5% increase over the 2016 base premium of $34.10.  (You might reme ...

Which tax return does the Social Security Administration use to determine my 2017 Medicare Part B and Medicare Part D Income-Related Monthly Adjustment Amount (IRMAA)?
Most likely your 2015 tax returns that were filed in 2016.  Your 2017 Income-Related Monthly Adjustment Amount (IRMAA) is based on the most recent tax return that the Internal Revenue Service ( ...

2016 CMS Press release: "Medicare projects relatively stable average prescription drug premiums in 2017"
The Centers for Medicare and Medicaid Services (CMS) recently announced that average monthly Medicare Part D premiums should remain relatively stable in 2017.  Based on the Medicare Part D plan c ...

An explanation of the 2017 Medicare Part D Coverage Gap or Donut Hole.
The Medicare Part D Coverage Gap or Donut Hole is actually similar to a second deductible in an insurance policy where you are responsible for paying your own coverage.  With the introduction of ...

How much money could I possibly save with the 2017 Donut Hole Discount?
About $2,458 - maybe even a little more depending on your Medicare Part D plan. Your actual savings in the 2017 Donut Hole will depend on several things including: (1) How much you spent personally ...




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Tips & Disclaimers
  • The Medicare Advantage and Medicare Part D prescription drug plan data on our site comes directly from Medicare and is subject to change.
  • Medicare has neither reviewed nor endorsed the information on our site.
  • We provide our Q1Medicare.com site for educational purposes and strive to present unbiased and accurate information. However, Q1Medicare is not intended as a substitute for your lawyer, doctor, healthcare provider, financial advisor, or pharmacist. For more information on your Medicare coverage, please be sure to seek legal, medical, pharmaceutical, or financial advice from a licensed professional or telephone Medicare at 1-800-633-4227.
  • We are an independent education, research, and technology company. We are not affiliated with any Medicare plan, plan carrier, healthcare provider, or insurance company. We are not compensated for Medicare plan enrollments. We do not sell leads or share your personal information.
  • Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. Our PDP-Compare.com and MA-Compare.com provide highlights of annual plan benefit changes.
  • The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan.
  • Limitations, copayments, and restrictions may apply.
  • We make every effort to show all available Medicare Part D or Medicare Advantage plans in your service area. However, since our data is provided by Medicare, it is possible that this may not be a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.
  • When enrolling in a Medicare Advantage plan, you must continue to pay your Medicare Part B premium.
  • Medicare beneficiaries with higher incomes may be required to pay both a Medicare Part B and Medicare Part D Income Related Monthly Adjustment Amount (IRMAA). Read more on IRMAA.
  • Medicare Advantage plans that include prescription drug coverage (MAPDs) are considered Medicare Part D plans and members with higher incomes may be subject to the Medicare Part D Income Related Monthly Adjustment Amount (IRMAA), just as members in stand-alone Part D plans. In certain situations, you can appeal IRMAA.
  • You must be enrolled in both Medicare Part A and Part B to enroll in a Medicare Advantage plan. Members may enroll in a Medicare Advantage plan only during specific times of the year. Contact the Medicare plan for more information.
  • If you are enrolled in a Medicare plan with Part D prescription drug coverage, you may be eligible for financial Extra Help to assist with the payment of your prescription drug premiums and drug purchases. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or your state Medicaid Office.
  • Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next.
  • A Medicare Advantage Private Fee-for-Service plan (PFFS) is not a Medicare supplement plan. Providers who do not contract with the plan are not required to see you except in an emergency.
  • Disclaimer for Institutional Special Needs Plan (SNP): This plan is available to anyone with Medicare who meets the Skilled Nursing Facility (SNF) level of care and resides in a nursing home.
  • Disclaimer for Dual Eligible (Medicare/Medicaid) Special Needs Plan (SNP): This plan is available to anyone who has both Medical Assistance from the State and Medicare. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.
  • Disclaimer for Chronic Condition Special Needs Plan (SNP): This plan is available to anyone with Medicare who has been diagnosed with the plan specific Chronic Condition.
  • Medicare MSA Plans combine a high deductible Medicare Advantage Plan and a trust or custodial savings account (as defined and/or approved by the IRS). The plan deposits money from Medicare into the account. You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins.
  • Medicare MSA Plans do not cover prescription drugs. If you join a Medicare MSA Plan, you can also join any separate (stand-alone) Medicare Part D prescription drug plan
  • There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. Those who disenroll during the calendar year will owe a portion of the account deposit back to the plan. Contact the plan provider for additional information.
  • Medicare beneficiaries may enroll through the CMS Medicare Online Enrollment Center located at www.medicare.gov.
  • Medicare beneficiaries can file a complaint with the Centers for Medicare & Medicaid Services by calling 1-800-MEDICARE 24 hours a day/7 days or using the medicare.gov site. Beneficiaries can appoint a representative by submitting CMS Form-1696.