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Q1Medicare.com - Medicare Prescription Drug Plans: FAQs

Browse the Most Viewed and Newest Medicare Part D FAQs
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Most Viewed FAQs

What is a Medicare Part D plan?
Medicare Part D prescription drug plans provide insurance coverage for your out-patient prescription drugs - so Medicare Part D plans work just like any other types of insurance: (1) you usually pa . . .
How will I choose between a stand-alone Medicare Part D prescription drug plan (PDP) and a Medicare Advantage plan that includes prescription drug coverage (MAPD)?
Medicare prescription drug coverage is available through either stand-alone Medicare Part D prescription drug plans (PDPs) or Medicare Advantage plans that include prescription drug coverage (MAPDs) . . .
How do I drop my Medicare Part D prescription drug plan?
You can drop, disenroll, or cancel your Medicare Part D plan or Medicare Advantage plan coverage during the annual Open Enrollment Period - or a Special Enrollment Period - or you can be involuntarily disenrolled from your plan.
What are the Medicare Part D Special Enrollment Periods (SEP)?
A Special Enrollment Period (SEP) allows a Medicare beneficiary to join, switch, or drop their Medicare Part D prescription drug plan (PDP) or Medicare Advantage plan (MA or MAPD) outside of the Ann . . .
What kind of discount can we expect in the Medicare Part D Donut Hole or Coverage Gap?
Starting back in the 2011 Medicare Part D plan year, a discount or co-insurance (cost-sharing) was introduced to reduce the cost of generic and brand-name prescription drugs purchased by non-LIS . . .
I did not enroll in a Medicare Part D plan when I was first eligible, how do I calculate my Medicare Part D late-enrollment premium penalty?
If you did not enroll into a Medicare Part D prescription drug plan during your Initial Enrollment Period (IEP) and you did not have other creditable prescription coverage (like VA or employer benefit . . .
Are Medicare Advantage plans the same as Medicare Supplements or Medigap plans?
No. Medicare Advantage plans are not the same as Medicare Supplements or Medigap policies. Medigap policy design. Medicare Supplements (also called Medigap policies) work togethe . . .
What is the Qualified Medicare Beneficiary (QMB) program and how can it save me money?
The Qualified Medicare Beneficiary (QMB) program is one of four Medicare Savings Programs (QMB, SLMB, QI, and QDWI) established by Medicare to help low-income Medicare beneficiaries pay their Medicare . . .
What is the BIN, PCN, and RxGROUP number for my Medicare Part D prescription drug plan?
Your (1) Member ID number, (2) Rx BIN, (3) PCN, and (4) Group ID (or Rx Group) number are the four numbers that uniquely identify you and your Medicare Part D prescription drug plan - and these four n . . .
How can I get financial "extra help" with my Medicare Part D prescription drug costs?
To apply for the Medicare Part D Extra Help program: You can call the Social Security Administration about the Extra Help program at 1-800-772-1213, Monday through Friday between 7 am an . . .

Newest FAQs

Does my Medicare supplement insurance (Medigap) policy cover me when I travel outside the U.S.?
If your Medigap policy is type C, D, E, F, G, H, I, J, M or N; your plan may offer additional coverage for health care services or supplies that you get outside the U.S.
Remember to Protect Yourself Against the Sun, Heat, and Humidity
As we move toward the warmer months of the year, we need to think more about the combination of sun, heat, and humidity and protecting ourselves during these longer, warmer days.
Do you have a Donut Hole calculator or a way to estimate my annual Medicare Part D spending?
Yes. Our Medicare Part D Donut Hole calculator or PDP-Planner is designed so seniors and other Medicare beneficiaries can see how their Part D drug spending could change throughout the year and . . .
What is the Medicare Advantage Open Enrollment Period (MA OEP)?
The Medicare Advantage Open Enrollment Period (MA OEP) is another enrollment period allowing people currently enrolled in a Medicare Advantage plan (MAPD or MA) an opportunity to change Medicare Advan . . .
Is there a Special Enrollment Period for Medicare beneficiaries affected by a Major Disaster like a hurricane, typhoon, wildfire, flood, or earthquake?
Yes. If you live in an area where the Federal Emergency Management Agency (FEMA) declared an emergency or major disaster, and you were not able to take advantage of an enrollment period (such as . . .
How much can the cost of a common generic drug vary between Medicare Part D plans and pharmacies?
As shown in the actual examples below, your generic drug costs can vary widely between Medicare Part D plans and between the pharmacies used by the Medicare Part D plans. A little background on dru . . .
How will my Medicare Part D prescription drug plan actively fight the opioid epidemic?
Starting in 2019, your Medicare Part D plan (MAPD or PDP) will implement a drug management program (or drug utilization management) to monitor and limit at-risk Medicare beneficiaries’ access to . . .
Can I compare my Medicare Part D retail drug costs to the the estimated cost using a non-Part D Drug Discount card?
Yes. You can use our Medicare Part D Drug Finder (Q1Rx.com) to see how all Medicare Part D prescription drug plans (PDPs) or Medicare Advantage plans that include drug coverage (MAPDs) in your . . .
What is indication-based utilization management and how will it affect Medicare Part D plan members?
Indication-based utilization management (or indication limitations) is a newly introduced type of utilization management that a Medicare Part D prescription drug plan can implement along with the plan . . .
Do you have an online Formulary Browser that I can use to see the prescriptions covered by my Medicare Part D plan?
Yes. We have our Formulary Browser online that includes every Medicare Part D and Medicare Advantage plan formulary or drug list and all formularies are formatted for alphabetical browsing. . . .