You will receive a 75% discount on all formulary drugs if you reach the Donut Hole or Coverage Gap.
As background, starting back in the 2011 Medicare Part D plan year, a discount or
co-insurance ( . . .
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) . . .
Your Initial Coverage Limit (ICL) is the "boundary" between your Medicare Part D plan's Initial Coverage Phase (where you and your drug plan share the cost of your drug purchases) and the Coverage Gap (where you receive a fixed 75% Donut Hole discount on formulary drugs
In general, you must show that your failure to make timely premium payments was due to
unique, unusual, or unexpected circumstances over which you had no control and could not
reasonably have been e . . .
Sometimes your Medicare plan will not have enough time to organize the automatic premium deduction from your Social Security check, resulting in a 3+ month delay in premium payments - and instead the plan will ask that you pay the premium directly until auto deductions can begin.
You will never pay more than your Medicare Part D plan's negotiated retail drug price - so even when your low-costing generic drug is placed on an expensive formulary tier - you will pay the lower retail cost and not the higher co-pay.
Yes. If you use a Special Enrollment Period (SEP) to change Medicare drug plans during the year, you will find that both the total retail value of your drug purchases and the total value of your out-of-pocket spending (TrOOP) transfer to your new Part D plan.
Yes, "when [these medications are] used to treat epilepsy, cancer, or a chronic mental health disorder".
A certain group of prescription medications are specifically excluded from Medicare Part D p . . .
In general, "creditable" prescription drug coverage is considered by Medicare to be "as generous as, or more generous than" (or at least as good as) standard Medicare Part D prescription drug coverage . . .
There are several reasons why you are paying more this year for your drugs even when you are in the same Medicare plan: Your drugs are no longer covered or covered at a higher price, you used a non-network or standard pharmacy, you lost Extra Help benefits, and more . . .
Q1Medicare offers a series of online tools to help you review and analyze Medicare Part D plans and Medicare Advantage plans (including plan finders, drug finders, and cost calculators). This FAQ includes an overview of our Q1Medicare online tools - along with a few tool tips.
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 . . .
There are several ways to contact your Medicare Part D or Medicare Advantage plan: (1) Call the toll-free telephone number found on your Member ID card. (2) Call the toll-free telephone number we provide in our Medicare Plan Finders. (3) Call a Medicare representative.
Yes, even though Medicare Advantage plans (MA or MAPD) usually have a service area for a specific county or ZIP code - and may not be as "portable" as a Medicare Supplement - you can travel with your . . .
No. A Medicare Part D plan will not allow you to request a tiering exception for a drug (moving a drug to a lower-costing formulary tier) when your plan has just approved your formulary exception request to cover the non-formulary drug.
Medicare Part D plans provide insurance coverage for prescription drugs - and just like any other type of insurance - you pay a monthly premium to a private company (like Aetna or Humana or UnitedHeal . . .