Q1Medicare.com - Medicare Prescription Drug Plans: FAQs

Jun, 02 2023 — No. Do not simply mail a premium payment check to your Medicare plan. Contact your plan's Member Services department and explain your situation, confirming your mailing address. Then make an alternative premium payment if necessary while awaiting your new Coupon Book's arrival.

May, 31 2023 — The Medicare annual Open Enrollment Period is the same every year - and begins on October 15th and continues for seven (7) weeks through December 7th. During the AEP, you can join, change, or drop . . .

May, 31 2023 — On January 1st, your Medicare Part D plan will start over - and you will no longer be in the Coverage Gap. If your Medicare Part D plan has an initial deductible, you will need to pay the initial d . . .

May, 31 2023 — Yes.  Medicare Part D prescription drug coverage is voluntary and you can use a Drug Discount Coupon or Drug Discount Card to purchase your medications instead of your Medicare Part D plan covera . . .

May, 31 2023 — The list of abbreviations used by the Centers for Medicare and Medicaid Services (CMS) describing the Medicare Part D or Medicare Advantage program can be rather long (about 140 pages or so), so here . . .

May, 31 2023 — No.  If you qualify for the Medicare Part D Extra Help program or Low-Income Subsidy (LIS), then you will never enter the Donut Hole or Coverage Gap -- and the cost of your prescriptions will r . . .

May, 31 2023 — You enter the Medicare Part D Donut Hole when the retail cost of your formulary drug purchases exceeds your plan's Initial Coverage Limit (ICL) and you exit the Coverage Gap or Donut Hole when your ou . . .

May, 31 2023 — No, your original Medicare coverage does not include Lifeline or any other Personal Emergency Response or Alert System as a benefit. However, it is possible that Medicaid or another state agency wi . . .

May, 31 2023 — Maybe.  If a person is disenrolled from their Medicare Part D or Medicare Advantage plan for failure to pay their monthly premiums and wants to re-enroll in their Medicare Part D plan So yes, . . .

May, 31 2023 — Here are 5 ways to see how close you are to your Donut Hole or Coverage Gap. Reminder about the Donut Hole "closing":  Although we say that the Donut Hole "closed" in 2020 since you receive a . . .

May, 31 2023 — If you submit an incomplete Medicare plan enrollment application and do not select a payment option, your newly chosen Medicare plan will usually call you to add any missing information. However, . . .

May, 31 2023 — Contact the Social Security Administration (1-800-772-1213 (TTY 1-800-325-0778) during operating hours, Monday through Friday, from 7 a.m. to 7 p.m.) or visit your local Social Security office (here i . . .

May, 31 2023 — If you are becoming eligible for Medicare during 2018, it will probably depend on the time of year when Medicare is issuing new Medicare cards and where you live to determine whether you receive an ol . . .

May, 31 2023 — Review your Explanation of Benefits.  Each month, your Medicare prescription drug plan will send you a printed Explanation of Benefits letter that will show you how close you are to entering . . .

May, 31 2023 — We include the size of all Medicare Part D prescription drug plan formularies in our stand-alone Medicare Part D Plan Finder (PDP-Finder.com) and our Medicare Advantage Plan Finder (MA-Finder.com). . . .

May, 31 2023 — Some abbreviations on your Medicare Part D plan's formulary are for Usage Management Restrictions or to further clarify the coverage details under your particular Medicare Part D prescription drug pla . . .

May, 31 2023 — No need to wait - you can enroll now into a new Medicare plan.  Most people are not allowed to change Medicare Part D prescription drug or Medicare Advantage plans outside of the annual Open E . . .

May, 31 2023 — Even if your Medicare Part D plan has no coverage in the gap, starting in 2011, you receive a discount on your medications while in the coverage gap. For generic drugs, you would pay the following per . . .

May, 31 2023 — 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 . . .

May, 30 2023 — Medicare Part D plans can change formulary or drug list designs each year and your Medicare prescription drug plan may have implemented utilization management (or drug usage management) restrictions i . . .

Feb, 12 2023 — 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 . . .

May, 06 2023 — Medicare Part D prescription drug plans provide insurance coverage for your out-patient prescription drugs - and works just like any other type of insurance: (1)  Monthly premium.  You us . . .

Feb, 12 2023 — You will receive a 75% discount on all formulary drugs if you reach the Donut Hole or Coverage Gap. Changes coming to the Medicare Part D Donut Hole. Spoiler Alert: In 2025, the Inflation Reductio . . .

Feb, 12 2023 — No.  Medicare Advantage plans are not the same as Medicare Supplements or Medigap policies. And here are a few key differences between the plans: Medigap policy design Medica . . .

Feb, 12 2023 — 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.

Feb, 16 2023 — 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 . . .

May, 31 2023 — 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 . . .

Apr, 28 2023 — If you are eligible for Medicare and you don't have drug coverage through your employer, VA, or other source, additional prescription drug coverage is available to you through either: (1) a stand-a . . .

May, 28 2023 — 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 drug coverage (like VA benefits or e . . .

May, 26 2023 — Yes.  Medicare Part D prescription drug plans do cover the shingles vaccine (stand-alone Medicare Part D plans and Medicare Advantage plans that include drug coverage).  And, beginning Janua . . .

Mar, 16 2023 — 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 . . .

Apr, 28 2023 — 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 . . .

Dec, 19 2022 — 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 quarterly Special Enrollment Period and can . . .

Mar, 28 2023 — Yes. In 2023, over 3,000 counties (or ZIP code areas) include at least one Medicare Advantage plan with a Part B premium “Giveback” - or about 23,000 unique plan/county combinations of different Medicare Advantage plans - 2023 Part B give-backs can range up to $170.10.

May, 05 2023 — No Medicare and Humana are not the same. Humana is one of the largest private insurance companies that provides, along with other products, Medicare Advantage plans and Medicare Part D prescripti . . .

Feb, 12 2023 — If you are a person who has higher annual earnings, the Income-Related Monthly Adjustment Amount (or IRMAA) is an additional amount that you pay for your monthly Medicare Part D prescription drug plan . . .

Mar, 16 2023 — A Medicare Advantage MAPD (or MA-PD) plan includes Medicare Part D prescription drug coverage and a Medicare Advantage MA plan does not include drug coverage. Both MAs and MAPDs provide coverage of your Medicare Part A (in-patient care) and Medicare Part B (out-patient care).

Feb, 16 2023 — TrOOP or your total out-of-pocket cost is the total amount you will spend in a year on your formulary drugs before exiting the Coverage Gap (or Donut Hole) and entering the Catastrophic Coverage of yo . . .

Mar, 16 2023 — An HMO POS is a Health Maintenance Organization with a Point of Service Option. An HMO POS is a Medicare Advantage Plan that is a Health Maintenance Organization with a more flexible network allowi . . .

Mar, 16 2023 — Yes.  A stand-alone Medicare Part D prescription drug plan (or PDP) only provides out-patient prescription drug coverage. However, a Medicare Advantage plans provide coverage for your Origina . . .