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Mar, 21 2023 — If you have Medicare and full Medicaid coverage, you are eligible for the Medicare Part D Extra Help or the Low-Income Subsidy (LIS) program and you are granted a Special Enrollment Period (SEP) that . . .
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Mar, 20 2023 — Yes, in some situations you have the right to ask your Medicare prescription drug plan to move a formulary medication to a lower-costing formulary tier. But, you cannot reduce the cost of a Tier 5 Specialty drug, nor can you reduce the cost of a now-covered, non-formulary drug.
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Mar, 20 2023 — A PDP is a stand-alone Medicare Part D prescription drug plan (only offering drug coverage) and a MADP is a Medicare Advantage plan that includes prescription drug coverage along with Medicare Part A and Part B coverage - and maybe even additional or supplemental benefits.
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Mar, 20 2023 — A Medicare Part D PDP is a Medicare prescription drug plan that provides insurance coverage for a specific list of out-patient prescription drugs at participating pharmacies. Your prescription drug costs should be lower with a PDP.
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Mar, 20 2023 — Yes. Your Explanation of Benefits (EOB) is a monthly statement that your Medicare Part D prescription drug plan (or Medicare Advantage plan) will send
you to explain your year-to-date Medicare . . .
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Mar, 20 2023 — Yes. Although, Medicare Part D drug plans must continue to cover a medication dropped from the plan’s formulary until the end of the plan year for anyone using the particular medication, Medicare allows several exceptions when a drug plan can drop a formulary drug mid-year.
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Mar, 20 2023 — Yes. You can use our Q1Rx® 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 (MAPD . . .
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Mar, 18 2023 — As noted by the Social Security Administration, the Qualified Disabled Working Individuals (QDWI) program is a Medicare Savings Program that is for people who are under the age of 65, disabled, and no . . .
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Mar, 18 2023 — The Qualifying Individual (QI) program is one of four Medicare Savings Programs (QMB, SLMB, QI, and QDWI) established by Medicare. QI helps low-income Medicare beneficiaries pay their Medicare P . . .
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Mar, 18 2023 — A Medicare Savings Program (MSP) is one of four different Medicaid programs (QMB, SLMB, QI, QDWI) available for people with limited financial resources and, depending on a person's income and assets, . . .
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Mar, 18 2023 — 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 . . .
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Mar, 18 2023 — The prior notification of a mid-year formulary change will depend on the type of formulary change. Your Medicare drug plan does not need to provide you prior notification if a newly-introduced generic drug replaces a brand-name formulary drug or the FDA recalls a formulary drug.
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Mar, 18 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 . . .
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Mar, 18 2023 — Drug Tiers are an attempt to "logically" group drugs (such as generics, preferred-generics, brand drugs, and specialty drugs) within a list (drug formulary).
All of your Medicare Part D prescriptio . . .
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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 . . .
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Mar, 16 2023 — Yes. In 2023, the Inflation Reduction Act (IRA) of 2022
introduces a provision similar to the 2021-2022 Senior Savings Model
with insulin provided at a $35 30-day co-pay throughout all phases . . .
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Mar, 16 2023 — The Centers for Medicare and Medicaid Services (CMS) periodically releases the enrollment figures for Medicare Part D and Medicare Advantage plans and we included this information in our Medicare Part . . .
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Mar, 16 2023 — Only in limited circumstances. Usually a person cannot be enrolled in a Medicare Advantage plan that does not include drug coverage and then add a separate stand-alone Medicare Part D drug plan . . .
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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).
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Mar, 16 2023 — Your Medicare Advantage plan’s Maximum Out-of-Pocket Limit (MOOP) is the total amount you will spend this year on in-network co-payments and co-insurance for covered or eligible Medicare Part A and Medicare Part B medical services - but, some healthcare coverage may be excluded