Frequently Asked Questions about Q&A of the Day

Feb, 26 2025 — 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 . . .

Nov, 14 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, 17 2025 — 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 . . .

Oct, 29 2023 — Within 2 to 3 months.  Depending on any administrative issues, you can usually expect your Social Security check premium deductions to begin within 2 to 3 months after the start of a new Medicare . . .

Jun, 06 2024 — You can call the Social Security Administration to report the death of a Medicare beneficiary at 1-800-772-1213 (TTY 1-800-325-0778). As noted on the Social Security Administration site: "You ca . . .

Apr, 08 2025 — In general, if you were involuntarily disenrolled from your Medicare Part D plan for not paying your monthly premiums, you must show that your failure to make timely premium payments was due to uniqu . . .

Nov, 11 2023 — 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.

Aug, 04 2024 — Your Medicare Part D late-enrollment penalty is calculated by multiplying the number of months you were without some form of "creditable" prescription drug coverage by 1% of the annual base Medicare Part D premium ($34.70 in 2024).

Mar, 19 2025 — 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.

Jan, 08 2025 — 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 copay.

Mar, 09 2025 — Maybe. If you are able to change or transfer to another Medicare Advantage plan offered by the same company during the plan year, you may be able to transfer the amount that you have spent for your Medicare Part A and Part B coverage toward your new plan's MOOP limit.

May, 24 2024 — The Centers for Medicare and Medicaid Services (CMS) provides the following guidance explaining how Medicare beneficiaries can receive a refund or repayment of their overpaid copayments and premiums f . . .

Apr, 04 2025 — Yes, in most cases.  When you move out of your Medicare Part D (PDP) or Medicare Advantage (MA or MAPD) plan's service area, you are granted a Special Enrollment Period to join another Medicare . . .

Dec, 04 2024 — No.  You do not need to cancel or disenroll from your existing Medicare Part D plan before enrolling in a new Medicare Part D prescription drug plan. When you change Medicare Part D prescripti . . .

Feb, 22 2025 — The Initial Coverage Phase is the second part of your Medicare drug plan and follows the Initial Deductible (if your plan has a deductible). During this phase, you and your Medicare Part D plan share in the cost of your formulary drugs (for example, you pay $47 for a $500 drug).

Aug, 15 2024 — Your monthly Medicare Part D IRMAA (Income-Related Monthly Adjustment Amount) charges will be deducted automatically from your Social Security check, or . . . . . . If the amount of your Social Sec . . .

Nov, 13 2024 — Yes.  If you are a Medicare beneficiary and your annual income (MAGI) exceeds certain limits - and you are enrolled in a Medicare Advantage plan (HMO, PPO, or PFFS) that includes prescription dru . . .

Dec, 11 2024 — Forever, except for a few situations.  The late-enrollment premium penalty (LEP) is permanent for most people over 65 and you will pay the penalty as long as you are enrolled in a Medicare Part D . . .

Feb, 03 2025 — The Medicare Part D Extra Help or Low-Income Subsidy (LIS) program helps people with limited financial resources pay for their Medicare Part D prescription drug coverage. If you receive Medicare Pa . . .

Apr, 11 2025 — No, TrOOP does not count toward your Medicare Advantage plan's MOOP limit.  TrOOP and MOOP are two different measures of out-of-pocket (OOP) costs - and TrOOP and MOOP are not related, aside from . . .

May, 03 2025 — 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.

Apr, 11 2025 — No, TrOOP does not count toward your Medicare Advantage plan's MOOP limit.  TrOOP and MOOP are two different measures of out-of-pocket (OOP) costs - and TrOOP and MOOP are not related, aside from . . .

Apr, 08 2025 — In general, if you were involuntarily disenrolled from your Medicare Part D plan for not paying your monthly premiums, you must show that your failure to make timely premium payments was due to uniqu . . .

Apr, 08 2025 — Maybe. This particular Special Enrollment Period (SEP) is exceptional, and will only be granted if the changes to your provider network are considered as "significant". In addition, you cannot simply . . .

Apr, 08 2025 — 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.

Apr, 08 2025 — Not always.  It is always worth checking Drug Discount Card prices, but be sure to compare these discount prices to your Medicare plan's coverage cost or negotiated retail drug price and you may . . .

Apr, 04 2025 — Yes, in most cases.  When you move out of your Medicare Part D (PDP) or Medicare Advantage (MA or MAPD) plan's service area, you are granted a Special Enrollment Period to join another Medicare . . .

Mar, 19 2025 — 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.

Mar, 17 2025 — 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 . . .

Mar, 11 2025 — The complete list of Medicare abbreviations used by the Centers for Medicare and Medicaid Services (CMS) describing Medicare Part D prescription drug plans or Medicare Advantage plans is rather long ( . . .

Mar, 09 2025 — Maybe. If you are able to change or transfer to another Medicare Advantage plan offered by the same company during the plan year, you may be able to transfer the amount that you have spent for your Medicare Part A and Part B coverage toward your new plan's MOOP limit.

Feb, 26 2025 — 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 . . .

Feb, 26 2025 — 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 . . .

Feb, 22 2025 — Not always.  If you are "Dual Eligible", qualifying for both Medicare and Medicaid, you will automatically qualify for the Medicare Part D Low-Income Subsidy (LIS) or Extra Help program. If . . .

Feb, 22 2025 — The Initial Coverage Phase is the second part of your Medicare drug plan and follows the Initial Deductible (if your plan has a deductible). During this phase, you and your Medicare Part D plan share in the cost of your formulary drugs (for example, you pay $47 for a $500 drug).

Feb, 03 2025 — The Medicare Part D Extra Help or Low-Income Subsidy (LIS) program helps people with limited financial resources pay for their Medicare Part D prescription drug coverage. If you receive Medicare Pa . . .

Jan, 27 2025 — 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 . . .

Jan, 16 2025 — About 10 business days.  Usually you will receive your "Welcome" information - including your new Member ID card from your Medicare plan within 7 to 10 business days - after Medicare approves you . . .

Jan, 08 2025 — 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 copay.

Dec, 11 2024 — Forever, except for a few situations.  The late-enrollment premium penalty (LEP) is permanent for most people over 65 and you will pay the penalty as long as you are enrolled in a Medicare Part D . . .