Frequently Asked Questions about Living with Your Medicare Part D Plan

Aug, 08 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 . . .

Aug, 02 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.

Aug, 18 2023 — Please contact your Medicare prescription drug plan's Member Services department (Medicare Part D or Medicare Advantage plan) directly to receive your replacement Member ID card. The toll-free numb . . .

Jul, 10 2023 — 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 . . .

Apr, 09 2023 — 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 . . .

Jul, 20 2023 — A few 2023 Medicare Advantage plans cover Fioricet with Codeine and Fioricet without Codeine, however no stand-alone Medicare Part D plans cover Fioricet with or without Codeine. For example, the 2 . . .

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 . . .

Jul, 23 2023 — 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 . . .

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 . . .

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, 23 2023 — Unfortunately, we cannot provide a direct answer to that question. Medicare Part D Drug Plans can change their premiums every year and some Part D premiums have gone up every year - as in your case, a . . .

Jul, 08 2023 — 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 . . .

Sep, 01 2022 — 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 . . .

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, 03 2023 — The Maryland Senior Prescription Drug Assistance Program (SPDAP) Coverage Gap Subsidy was discontinued in 2021.  Now, Maryland SPDAP will pay up to $50.00 per month for your Medicare Rx prescript . . .

Jul, 11 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 . . .

Jun, 06 2023 — 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 . . .

Sep, 08 2022 — 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, 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, . . .

Jul, 19 2023 — An appeal is the process members can use when the plan makes a decision to deny coverage for a drug.  The member, the member's appointed representative, or, in some cases, the member's doctor can . . .

Aug, 18 2023 — Please contact your Medicare prescription drug plan's Member Services department (Medicare Part D or Medicare Advantage plan) directly to receive your replacement Member ID card. The toll-free numb . . .

Aug, 08 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 . . .

Aug, 02 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.

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, 23 2023 — Unfortunately, we cannot provide a direct answer to that question. Medicare Part D Drug Plans can change their premiums every year and some Part D premiums have gone up every year - as in your case, a . . .

Jul, 23 2023 — 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 . . .

Jul, 20 2023 — A few 2023 Medicare Advantage plans cover Fioricet with Codeine and Fioricet without Codeine, however no stand-alone Medicare Part D plans cover Fioricet with or without Codeine. For example, the 2 . . .

Jul, 19 2023 — An appeal is the process members can use when the plan makes a decision to deny coverage for a drug.  The member, the member's appointed representative, or, in some cases, the member's doctor can . . .

Jul, 12 2023 — 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 . . .

Jul, 11 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 . . .

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 . . .

Jul, 10 2023 — 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 . . .

Jul, 08 2023 — 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 . . .

Jun, 06 2023 — 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 . . .

May, 15 2023 — 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 . . .

May, 03 2023 — The Maryland Senior Prescription Drug Assistance Program (SPDAP) Coverage Gap Subsidy was discontinued in 2021.  Now, Maryland SPDAP will pay up to $50.00 per month for your Medicare Rx prescript . . .

Apr, 09 2023 — 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 . . .

Sep, 08 2022 — 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 . . .

Sep, 08 2022 — 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 . . .