Frequently Asked Questions about Living with your Part D plan

Jan, 26 2025 — 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 . . .

Feb, 11 2025 — 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.

Nov, 11 2024 — You do not need to do anything.  If your Medicare Advantage plan or Medicare Part D prescription drug plan is offered next year - and you make no enrollment decision - you will be automatically . . .

Jun, 07 2025 — Whether you have a stand-alone Medicare Part D plan or Medicare Advantage plan, you will need to contact your Medicare prescription drug plan's Member Services department directly to request a replace . . .

Apr, 11 2025 — The Centers for Medicare and Medicaid Services (CMS) have implemented safe-guards to protect Medicare beneficiaries who inadvertently missed a Medicare Part D premium payment and require Medicare p . . .

Jun, 05 2025 — No.  There are no 2025 Medicare Part D plans that cover Fioricent/Codine -- this includes both stand-alone Part D plans (PDPs) and Medicare Advantage plans that include prescription drug coverage . . .

Mar, 14 2022 — You are correct in your assumption that Clonazepam is not covered by your Medicare Part D plans Clonazepam is not covered by any Medicare Part D plan. By design, certain classes of medication we . . .

Sep, 06 2022 — 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 . . .

Jun, 07 2025 — First, you can contact your chosen Medicare plan's Member Services department and check that your address was entered correctly and that your Member ID card (and plan information) was sent.  Whil . . .

Oct, 22 2024 — Your question is one that many people are also asking. If you drop your Medicare Part D coverage now, when you do decide to enroll in a Part D plan, you will pay an increased monthly premium based on . . .

Jun, 24 2024 — Medicare Part D drug plans can change their premiums year-to-year and some Part D premiums have gone up almost every year - nut, other Part D plans have reduced their monthly premiums. Most likely, . . .

Jul, 10 2023 — Your stand-alone Medicare Part D prescription drug plan (PDP) only provides coverage for your prescription medications and probably does not include a fitness benefit. However, many Medicare Advant . . .

Apr, 08 2025 — Yes.  As noted by the Centers for Medicare and Medicaid Services (CMS), a Medicare Part D or Medicare Advantage plan can disenroll a plan member for non-payment of premiums after proper notice an . . .

Jul, 23 2023 — No. The Medicare Part D program is voluntary and, like any insurance-type program, you can choose to not use your prescription drug plan and pay your prescription costs out of your own pocket - althou . . .

May, 09 2025 — No.  You are not required to use your Medicare Part D plan even when you are buying a formulary drug at one of your Medicare plan's network pharmacies. However, except in certain situations (e . . .

Dec, 01 2019 — A Coverage Determination is any decision made by a Medicare Part D plan regarding payment or coverage benefits to which a Medicare plan enrollee believes he or she is entitled. More specifically, . . .

Apr, 20 2024 — If you have a prescription for a drug that isn't on your plan's formulary, you should ask your doctor if there is another drug you can take that is on your plan's formulary.  If your doctor can't . . .

Dec, 04 2024 — If you have recently enrolled in a Medicare plan and still have not received your new Medicare Part D or Medicare Advantage plan Member ID card, please contact your Medicare plan’s Member Serv . . .

Jun, 06 2025 — An appeal is the process members can use when the plan makes a negative decision - such as when your plan denies coverage for a non-formulary drug (deny a Coverage Determination).The Medicare plan mem . . .

Apr, 20 2024 — Yes, your doctor can request an exception (or any other type of coverage determination) on your behalf.  In cases where delays may seriously affect your health, your doctor can also ask for an ex . . .

Jun, 07 2025 — Whether you have a stand-alone Medicare Part D plan or Medicare Advantage plan, you will need to contact your Medicare prescription drug plan's Member Services department directly to request a replace . . .

Jun, 07 2025 — First, you can contact your chosen Medicare plan's Member Services department and check that your address was entered correctly and that your Member ID card (and plan information) was sent.  Whil . . .

Jun, 06 2025 — An appeal is the process members can use when the plan makes a negative decision - such as when your plan denies coverage for a non-formulary drug (deny a Coverage Determination).The Medicare plan mem . . .

Jun, 06 2025 — Most costs associated with home infusion therapy fall under Medicare Part B benefits. However, keep in mind that insulin pump systems are not considered home infusion therapy and fall under Medicare . . .

Jun, 05 2025 — No.  There are no 2025 Medicare Part D plans that cover Fioricent/Codine -- this includes both stand-alone Part D plans (PDPs) and Medicare Advantage plans that include prescription drug coverage . . .

May, 09 2025 — No.  You are not required to use your Medicare Part D plan even when you are buying a formulary drug at one of your Medicare plan's network pharmacies. However, except in certain situations (e . . .

Apr, 11 2025 — The Centers for Medicare and Medicaid Services (CMS) have implemented safe-guards to protect Medicare beneficiaries who inadvertently missed a Medicare Part D premium payment and require Medicare p . . .

Apr, 08 2025 — Yes.  As noted by the Centers for Medicare and Medicaid Services (CMS), a Medicare Part D or Medicare Advantage plan can disenroll a plan member for non-payment of premiums after proper notice an . . .

Feb, 11 2025 — 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.

Jan, 26 2025 — 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 . . .

Dec, 04 2024 — If you have recently enrolled in a Medicare plan and still have not received your new Medicare Part D or Medicare Advantage plan Member ID card, please contact your Medicare plan’s Member Serv . . .

Nov, 11 2024 — You do not need to do anything.  If your Medicare Advantage plan or Medicare Part D prescription drug plan is offered next year - and you make no enrollment decision - you will be automatically . . .

Oct, 22 2024 — Your question is one that many people are also asking. If you drop your Medicare Part D coverage now, when you do decide to enroll in a Part D plan, you will pay an increased monthly premium based on . . .

Jun, 24 2024 — Medicare Part D drug plans can change their premiums year-to-year and some Part D premiums have gone up almost every year - nut, other Part D plans have reduced their monthly premiums. Most likely, . . .

Apr, 20 2024 — If you have a prescription for a drug that isn't on your plan's formulary, you should ask your doctor if there is another drug you can take that is on your plan's formulary.  If your doctor can't . . .

Apr, 20 2024 — Yes, your doctor can request an exception (or any other type of coverage determination) on your behalf.  In cases where delays may seriously affect your health, your doctor can also ask for an ex . . .

Jul, 23 2023 — No. The Medicare Part D program is voluntary and, like any insurance-type program, you can choose to not use your prescription drug plan and pay your prescription costs out of your own pocket - althou . . .

Jul, 10 2023 — Your stand-alone Medicare Part D prescription drug plan (PDP) only provides coverage for your prescription medications and probably does not include a fitness benefit. However, many Medicare Advant . . .

Jul, 10 2023 — Your first step would be to call the Member Services telephone number on the back of your Membership ID card to speak with someone about your claim. If you cannot find your plan’s contact inf . . .

Sep, 06 2022 — 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 . . .