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Q1Medicare.com - Latest Medicare News

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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 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 ...

2018 State Low-Income Subsidy Benchmark Premium Amounts - with a comparison of benchmark changes since 2006
The Centers for Medicare and Medicaid Services (CMS) released the 2018 low-income premium subsidy amounts (or Benchmark) for Medicare Part D plans on July 31, 2017, and in 2018, forty (40) states will ...

Does Medicare cover Vitamin B-12 injections (B-12 shots)?
Medicare Part D prescription drug plans usually do not provide coverage for vitamins.  However, in specific cases - or for specific conditions, Medicare will cover Vitamin B-12 injections.  ...

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 ...

2018 IRMAA: 35% to 58% Medicare Part D IRMAA payment increases for individual earning incomes between $133,500 - $214,000 and couples earning $267,000 - $428,000.
Since 2011, people with Medicare who earn over $85,000 have been paying an additional monthly premium or Income-Related Monthly Adjustment Amount (IRMAA) for their Medicare Part D prescription drug p ...

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 ...

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 ...

Roughly a 3% increase in the 2016 Income Related Monthly 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 ...

Understanding the 2018 Medicare Part D Coverage Gap or Donut Hole
The Donut Hole or Coverage Gap is a term used to describe a gap or pause in your Medicare Part D prescription drug plan or Medicare Advantage plan coverage where, prior to 2011, you were 100% respon ...

Latest News
Will you enter the 2018 Medicare Part D Coverage Gap or Donut Hole?
You will enter your Medicare Part D prescription drug plan's Donut Hole or Coverage Gap if the total retail value of your formulary prescription purchases exceeds your plan's Initial Coverage Limit ...

A preview of 2019: CMS releases the proposed 2019 Medicare Part D standard drug plan coverage parameters
On February 1st, the Centers for Medicare and Medicaid Services (CMS) released Part II of the 2019 Advance Notice and Draft Call Letter that included proposed defined standard benefits for 2019 Med ...

I am qualified for Medicaid and Medicare, so why am I still paying a premium for my 2018 Medicare Part D drug plan?
If you are qualified to receive Medicaid, then you automatically qualify for the Medicare Part D Extra Help program and the cost of your Medicare Part D premium will be covered up to a certain level & ...

I enrolled into a new 2018 Medicare Part D plan and still have not received my Member ID card. What should I do?
(1)  If you have received an enrollment confirmation or “Welcome” letter from your 2018 Medicare prescription drug plan, the letter should include your: (1) Member ID number, (2) P ...

CMS announces Medicare Special Enrollment Period (SEP) for people affected by Hurricane Harvey, Irma, Maria, Nate, and California wildfires
If you are a Medicare beneficiary affected by Hurricane Harvey, Irma, Maria, or Nate you are entitled to a "weather related emergency or major disaster" Special Enrollment Period (SEP) extending the 2 ...

The 2018 Medicare Part D annual Open Enrollment Period (AEP) ends today, December 7th.
As a last reminder, the 2018 annual Medicare Open Enrollment Period (AEP) ends tonight, Thursday, December 7th at midnight. During this final day of the 2018 AEP, you can still join, change, or dr ...

Changes in 2018 Medicare Part A and Part B Premiums and Deductibles
CMS NEWS: 2018 Medicare Parts A & B Premiums and Deductibles Announced. Summary of changes to Medicare Part A and Medicare Part B premiums and deductibles: Increase in SS Benefits.  ...

How is your 2017 Medicare plan changing in 2018?
We want to remind you that, if you decide to stay with your current 2017 Medicare plan into 2018, your Medicare plan coverage and costs can (and usually do) change each year - so please take time to ...

The 2018 Donut Hole Discount increases (... and what this means to you)
The 2018 Donut Hole discount will increase to 65% for all brand-name medications purchased in the Donut Hole (you pay 35% of the retail cost and get 85% credit toward TrOOP) and the 2018 generic Donut ...

Q1Group 2018 Medicare Plan Analysis: Over 1.2 million members in non-renewing 2017 Medicare Advantage plans may lose their 2018 Medicare plan coverage
Is your 2017 Medicare Part D prescription drug plan or Medicare Advantage plan still being offered in 2018? Each year, Medicare plans have the option of not renewing their Medicare contract.  ...




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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.