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2017 Federal Poverty Level Guidelines (FPL): 2017-2018 LIS Qualifications and Benefits
The 2017 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 ...

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 ...

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 ...

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 ...

Does Medicare Cover Vitamin B-12 Injections (Shots)?
In specific cases, Medicare will cover Vitamin B-12 injections (as noted in the text below as found in the Medicare benefits manual). Medicare Benefit Policy Manual Chapter 7 - Home Health Services ...

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 ...

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 ...

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 ...

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 2017 Medicare Pharmacy and Healthcare Provider Search Tools
You can find the 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:(1)&n ...

. Latest News


Is the Medicare Part D Donut Hole any different if I am enrolled in a Medicare Advantage plan that includes drug coverage?
No.  If your 2017 Medicare Advantage plan includes prescription drug coverage (MAPD), then the Donut Hole or Coverage Gap portion of your coverage works just like a stand-alone Medicare Part D ...

CMS lifts Cigna Medicare Part D and Medicare Advantage plan Marketing and Enrollment Sanctions
On Friday, June 16, 2017, the Centers for Medicare and Medicaid Services (CMS) lifted the sanctions imposed on Cigna Medicare Part D and Medicare Advantage plans and Cigna may once again market Medica ...

If I am in the 2017 Donut Hole and get a 60% discount on my brand-name drugs, what percent of my purchase counts toward exiting the Donut Hole?
90% of your brand-name drug's retail cost is counted toward exiting the 2017 Donut Hole. If your monthly purchases of formulary medications consistently have a retail value of over $309, you will e ...

In 2017, does the $4,950 out-of-pocket Donut Hole limit include the $3,700 Initial Coverage Limit so you only have to pay $1,250 ($4,950-$3,700) before leaving the Gap?
No.  Your $4,700 total out-of-pocket spending limit (2017 TrOOP) includes only the portion of your $3,700 Initial Coverage Limit that you actually paid for your medications - but, you cannot su ...

If I only use one brand drug that costs $347 and has a $47 co-pay, will I enter the 2017 Donut Hole?
Yes. If your retail drug costs are $347 a month you will enter your Medicare Part D plan's 2017 Coverage Gap or Donut Hole in late-October or early-November 2017. As a reminder . . . You will en ...

Preparing for an "Above-Normal" 2017 Hurricane Season
The 6-month 2017 Atlantic hurricane season started June 1st and forecasters at the National Oceanic and Atmospheric Administration (NOAA) predict an above-normal Atlantic hurricane season this year ...

CMS Press Release: New Medicare cards will be issued April 2018
New Medicare cards arriving April 2018.The Centers for Medicare & Medicaid Services (CMS) is currently preparing new Medicare cards for the 57.7 million Medicare beneficiaries. "The new cards w ...

April and May formulary changes: 2017 Medicare Part D drug lists now updated with 283 new prescription drugs
As you may know, Medicare Part D prescription drug plans can update their plan formularies or drug lists throughout the plan year and in the past two months, 283 new prescription medications have b ...

May 2017 Formulary Changes to the Top Medicare Drugs
The May, 2017 Medicare Part D plan formulary (or drug list) data included 43 new drug codes or NDCs representing 250 different medications. The NDC uniquely identifies a particular drug, manufacturer ...

May 2017 summary of the new medications added to Medicare Part D plan formularies (drug lists)
The May, 2017 Medicare Part D plan formulary data (or drug lists) includes the addition of 43 new National Drug Codes (NDC) to the Medicare Part D program.  These NDCs represent 33 different drug ...




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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.