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Q1Medicare.com - Latest Medicare News

Most Viewed News
What does the letter after my Medicare number mean?
March 2018 Update - Medicare Cards are Changing - New Card, Same BenefitsThe Centers for Medicare and Medicaid Services (CMS) is mailing new Medicare cards starting April 2018 and continuing through A ...

2018 Federal Poverty Level Guidelines (FPL): 2018 LIS Qualifications and Benefits
The 2018 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 Federal Poverty Level Guidelines (FPL): 2017-2018 LIS Qualifications and Benefits
Note: The 2018 Federal Poverty Level Guidelines (FPL): 2018 LIS Qualifications and Benefits are now available. The 2017 Federal Poverty Level (FPL) Guidelines determine the income level requirement ...

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 ...

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 ...

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 ...

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 ...

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
CMS Tip Sheet - Calculating the Late Enrollment Penalty (2018 Revision)
What is the Part D late enrollment penalty? The late enrollment penalty is an amount that may be added to a person's monthly Part D premium. A person enrolled in a Medicare drug plan may owe a late e ...

Changes are coming for 2019 Medicare Part D plans: A few highlights from the 2019 final CMS Call Letter and Final Rule
Seniors, Medicare plan providers, and caregivers can expect a few changes in the 2019 Medicare Part D program.  Below are a few highlights from the final 2019 Call Letter and a 1,156 page Medic ...

Looking toward 2019: CMS finalizes 2019 Medicare Part D standard drug plan coverage parameters
On April 2, 2018, the Centers for Medicare and Medicaid Services (CMS) released the 2019 Rate Announcement and Call Letter that includes the finalized defined standard benefits for 2019 Medicare Pa ...

Why don't more people take advantage of the "5-Star" Medicare plan Special Enrollment Period in 2018?
Limited plan availability. "5 Star" Medicare Part D and Medicare Advantage plans are available in only a few areas across the country. Currently, "5 Star" stand-alone Medicare Part D prescription drug ...

More than 6 million people can take advantage of the 2018 "5-Star" Medicare plan Special Enrollment Period.
More than 6 million people have access to 2018 Medicare Part D plans and Medicare Advantage plans with a 5-Star quality rating - and this means these people have the option of using a once-a-year Spec ...

Star Ratings for the 2018 Medicare Advantage Plans by Health Plan Type
Medicare uses information from member satisfaction surveys, plans, and health care providers to give overall performance star ratings to Medicare Advantage plans. These ratings are an incentive for Me ...

What is the 2018 standard Initial Coverage Limit and how does the ICL work?
The 2018 standard Initial Coverage Limit (ICL) is $3,750. The Initial Coverage Limit is the measured by the retail cost of your drug purchases and is used to determine when you leave your Medicare ...

What happens after the 2018 Out of Pocket Threshold (True Out of Pocket Cost or TrOOP limit) of $5,000 has been met?
This phase of your Medicare Part D coverage is called the Catastrophic Coverage phase and has the same cost-sharing for every Medicare Part D plan.   For generics or preferred brand drugs tha ...

Your New Medicare Card: What you need to know!
The Centers for Medicare and Medicaid Services (CMS) is mailing new Medicare cards to all 57.7 million Medicare beneficiaries starting April 2018 and continuing through April 2019*. As noted by CMS ...

How much money could I possibly save with the 2018 Donut Hole Discount?
About $2,809 - maybe even a little more depending on your Medicare Part D plan. However, your actual savings in the 2018 Donut Hole will depend on several things including: (1)  How much you ...




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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.