|•|| 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)...
|•|| I wish to drop my Medicare Part D prescription drug plan coverage - What should I do?
In general, you can only drop, disenroll, or cancel your Medicare Part D plan or Medicare Advantage plan coverage during the annual Open Enrollment Period (AEP) -- that runs each year from Octob...
|•|| What are the Medicare Part D Special Enrollment Periods (SEP)?
Usually, most seniors or other Medicare beneficiaries can only change their Medicare Part D or Medicare Advantage plan coverage during the annual Open Enrollment Period (AEP or Annual Enrollment Perio...
|•|| What is SLMB or a Specified Low Income Medicare Beneficiary?
SLMB is one type of Medicare Savings Program for the "Specified Low - Income Medicare Beneficiary" and, according to the Centers for Medicare and Medicaid Services (CMS), SLMB is defined as: "A Medic...
|•|| I am considering changing my prescription drug coverage to the Humana Walmart-Preferred Rx Plan and I was wondering if I can only go to Walmart for my prescriptions?
No, you do not have to use Walmart as your only pharmacy. The Humana Medicare Part D plans include over 50,000+ pharmacies in their pharmacy network. However, you may pay much more for your ...
|•|| If I decide not to join any Medicare prescription drug plan, and I do not have any other prescription coverage, how long will I have to pay the late-enrollment premium penalty?
Probably forever. The late-enrollment premium penalty is permanent for most people over 65 and you will pay the penalty as long as you are enrolled in a Medicare Part D prescription drug plan (o...
|•|| How does the Income-Related Monthly Adjustment Amount (or IRMAA) affect me and my Medicare plan premiums?
If you are paying IRMAA (the Income-Related Monthly Adjustment Amount), this means that, based on your income, you will pay higher premiums for your Medicare Part B and Medicare Part D coverage.As not...
|•|| 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 am on Medicaid and Medicare assigned me a Part D plan that does not cover one of my medications. What do I do?
You have two options: You can select a new Medicare Part D plan that covers all of your medications. Medicaid and "Extra Help" recipients both receive a continuous Special Enrollment Period and ca...
|•|| 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. ...
|•|| What discount will I receive for my tier 5 specialty drugs when I am in the Medicare Part D Donut Hole?
It depends on the drug. The formulary drug tier (such as a Tier 5 Specialty Drug) does not affect your Donut Hole discount.Instead, the discount you receive on your medications when reaching the...
|•|| How do I get a refund for over-paid Medicare Part D premiums and co-payments?
The Centers for Medicare and Medicaid Services (CMS) provides a "tip sheet" explaining how Medicare beneficiaries can receive a refund for their overpaid Medicare drug plan copayment and/or premiu...
|•|| I stopped working and now earn less than the IRMAA threshold, can I ask Social Security to reconsider my IRMAA premiums?
Yes. If your income has changed and moved you to a lower income-related monthly adjustment amount (IRMAA) bracket, you should consider filing an appeal to have your IRMAA premiums reconsidered...
|•|| What is a multi-source drug?
Multi-source drug is a term used by the Centers for Medicare and Medicaid Services (CMS or Medicare) distinguish between: Generic / Preferred Multi-Source Drug and Other Drugs ...
|•|| Will my drug cost increase when I enter the Donut Hole?
Maybe. As you move from your Initial Coverage Phase into the Coverage Gap, your savings -- or extra cost -- in the Donut Hole or Coverage Gap will depend on your Medicare Part D plan’s ini...
|•|| My new Medicare Part D coverage is much more expensive than last year. Can I still change to another Medicare Part D prescription drug plan after the AEP closes?
Maybe, depending on your situation. Most people cannot change their Medicare Part D plan coverage after the December 7th annual Open Enrollment Period (AEP) deadline. However, if you qua...
|•|| What do I need to know about my new Medicare card?
The Centers for Medicare and Medicaid Services (CMS) is mailing new Medicare cards to all 57.7 million Medicare beneficiaries (starting back in April 2018) and will continue through April 2019*. As...
|•|| Why are my medications costing more this year even though I didn't change Medicare Part D plans?
Annual Medicare plan changes and increases in your retail drug costs. Medicare Part D prescription drug plans can (and usually do) change every year and even if you stayed with your same plan f...
|•|| How does the Medicare Part D initial deductible work? I use a drug with a $47 co-pay, but had to pay $290.
In most cases, you must pay your Medicare Part D plan's initial deductible before you receive Medicare Part D coverage - just as you would with other types of insurance, such as automobile insurance. ...
|Q&A of the Day|
|Help! Where Do I Start?|
|General Medicare Part D (PDPs and MAPDs)|
|Medicare Advantage Plans (MAPD)|
|Medicare Supplements or Medigap|
|Choosing a Medicare Plan |
|Star Ratings & Medicare Plan Quality|
|Medicare Part D Enrollment|
|ANOC: Annual Plan Changes|
|Changing Medicare Part D Plans|
|Medicare Enrollment Periods (IEP and AEP)|
|Special Enrollment Periods (SEPs)|
|Medicare Plan Disenrollment|
|The Late-Enrollment Penalty (LEP)|
|Cost-sharing: What You Pay|
|Paying Your Premiums|
|Extra Help - LIS - Medicaid|
|IRMAA: Higher Incomes and Costs|
|Living with Your Medicare Part D Plan|
|Explanation of Benefits (EOB)|
|Pharmacies and Part D|
|Specific Healthcare Coverage|
|Medicare Plan Providers|
|Retail Drug Pricing|
|Understanding Your Formulary|
|Monthly Formulary Changes|
|Drug Usage Restrictions (QL, PA, ST)|
|Formulary Exceptions (Coverage Determinations)|
|Coverage of Specific Drugs|
|Diabetes and Diabetic Coverage|
|The Donut Hole or Coverage Gap|
|Entering the Donut Hole|
|Donut Hole Discounts|
|Closing the Coverage Gap|
|Exiting the Donut Hole|
|TrOOP and MOOP: Out of Pocket Costs|
|Traveling with Your Medicare plan|
|Moving and Medicare Part D|
|Drug Discount Cards|
|Using Part D with Other Drug Programs|
|VA and TRICARE Coverage|
|Employer Drug Coverage|
|Medicare Savings Account Plans (MSA)|
|New Medicare Cards|
|Medicare Part B|
|Medicare Set Aside Arrangements|
|Medicare and the ACA Marketplace|
|Online Tool Tips|
|Other Q1Medicare Tips and Questions|
|$250 Doughnut Hole Rebate (Only in 2010)|