Q1Medicare.com - Medicare Prescription Drug Plans: FAQs

May, 28 2023 — We are Q1Group LLC located in Saint Augustine, Florida and we operate the website Q1Medicare.com and provide information on all Medicare Part D and Medicare Advantage plans offered across the country . . .

May, 28 2023 — Cost-Sharing refers to the portion of your Medicare Part D or Medicare Advantage plan coverage that you pay yourself - such as $47 for a Tier 3 brand-name drug that usually costs $250 retail or $20 to visit your primary care physician (PCP) or $75 to see a healthcare specialist.

May, 28 2023 — If you did not enroll into a Medicare Part D prescription drug plan during your Initial Enrollment Period (IEP) and you did not have other creditable prescription drug coverage (like VA benefits or e . . .

May, 28 2023 — Your Medicare plan must tell you what you will pay for cost-sharing and cost-sharing information can be found in your plan's Summary of Benefits document (that you receive when enrolling in a Medica . . .

May, 27 2023 — All generics covered on your Medicare Part D plan's Formulary will receive the Donut discount.  The discount on generic drugs purchased in the Coverage Gap applies to all generics covered as form . . .

May, 26 2023 — Our Q1Medicare® PDP-Compare and MA-Compare tools allow you to compare annual Medicare changes in all stand-alone Medicare Part D prescription drug plans (PDPs) or Medicare Advantage plans (MA . . .

May, 26 2023 — Medicare prescription drug coverage is insurance for a specific list of out-patient prescription drugs and you use your drug coverage like any other types of insurance: (1) You may pay a monthly . . .

May, 26 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 . . .

May, 26 2023 — You can join a Medicare Part D or Medicare Advantage plan from October 15 - December 7 of each year. In most cases, if you don't join by December 7, and you don't currently have a drug plan that, . . .

May, 25 2023 — The maximum out-of-pocket spending limit for Part D prescription drugs. In 2024, RxMOOP will be the TrOOP threshold ($8,000) and then starting in 2025, RxMOOP will be $2,000 and will then change each year thereafter along with other Medicare Part D plan parameters.

May, 25 2023 — Medicare Part D Catastrophic Coverage is the fourth and final part of your Medicare Part D prescription drug plan coverage and is designed to help reduce the out-of-pocket spending for people with hi . . .

May, 25 2023 — The Q1Rx® Drug Finder is an online tool allowing you to quickly see how all Medicare Part D (PDPs) or Medicare Advantage plans (MAPDs) in your service area are covering a particular prescriptio . . .

May, 25 2023 — There are five U.S. territories that are covered by the Medicare Part D program and offer stand-alone Medicare Part D prescription drug plans: American Samoa Guam the Northern Ma . . .

May, 25 2023 — There are four possible parts to your Medicare drug plan coverage: (1) the Initial Deductible, (2) the Initial Coverage phase, (3) the Coverage Gap or Donut Hole, and (4) Catastrophic Coverage (all fo . . .

May, 25 2023 — 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 . . .

May, 25 2023 — Not exactly.  Although we say that the Donut Hole "closed" in 2020 since you receive a 75% discount on all formulary drugs purchased in the Donut Hole, the Coverage Gap still remains as the thi . . .

May, 25 2023 — It depends on when you want your Medicare Part D prescription drug coverage to begin. When you turn 65 and become eligible for Medicare, you will be granted a seven (7) month window of time in whic . . .

May, 25 2023 — Coinsurance is a type of cost-sharing used by Medicare Part D prescription drug plans or Medicare Advantage plans referring to a Medicare plan member paying a percentage of the medication's negotiated . . .

May, 25 2023 — Copayment or copay is a type of cost-sharing that refers to a fixed dollar amount you pay for a medication assigned to a logical grouping or Tier of medications. As reference, the Centers for Me . . .

May, 25 2023 — Your pharmacy can send a test claim through their point-of-sale system (POS) to check on the status of your membership, as long as you have either your membership card or the information from your mem . . .

Feb, 12 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 . . .

May, 06 2023 — Medicare Part D prescription drug plans provide insurance coverage for your out-patient prescription drugs - and works just like any other type of insurance: (1)  Monthly premium.  You us . . .

Feb, 12 2023 — You will receive a 75% discount on all formulary drugs if you reach the Donut Hole or Coverage Gap. Changes coming to the Medicare Part D Donut Hole. Spoiler Alert: In 2025, the Inflation Reductio . . .

Feb, 12 2023 — No.  Medicare Advantage plans are not the same as Medicare Supplements or Medigap policies. And here are a few key differences between the plans: Medigap policy design Medica . . .

Feb, 12 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.

Feb, 16 2023 — A Special Enrollment Period (SEP) allows a Medicare beneficiary to join, switch, or drop their Medicare Part D prescription drug plan (PDP) or Medicare Advantage plan (MA or MAPD) outside of the ann . . .

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 . . .

Apr, 28 2023 — 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 . . .

May, 28 2023 — If you did not enroll into a Medicare Part D prescription drug plan during your Initial Enrollment Period (IEP) and you did not have other creditable prescription drug coverage (like VA benefits or e . . .

May, 26 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, 16 2023 — If you are paying IRMAA (the Income-Related Monthly Adjustment Amount), this means that, based on your income, you will pay higher premiums for your Medicare Part B and Medicare Part D coverage. As . . .

Apr, 28 2023 — To apply for the Medicare Part D Extra Help program: You can call the Social Security Administration about the Extra Help program at 1-800-772-1213, Monday through Friday between 7 am an . . .

Dec, 19 2022 — You have two options: You can select a new Medicare Part D plan that covers all of your medications. Medicaid and "Extra Help" recipients both receive a quarterly Special Enrollment Period and can . . .

Mar, 28 2023 — Yes. In 2023, over 3,000 counties (or ZIP code areas) include at least one Medicare Advantage plan with a Part B premium “Giveback” - or about 23,000 unique plan/county combinations of different Medicare Advantage plans - 2023 Part B give-backs can range up to $170.10.

May, 05 2023 — No Medicare and Humana are not the same. Humana is one of the largest private insurance companies that provides, along with other products, Medicare Advantage plans and Medicare Part D prescripti . . .

Feb, 12 2023 — If you are a person who has higher annual earnings, the Income-Related Monthly Adjustment Amount (or IRMAA) is an additional amount that you pay for your monthly Medicare Part D prescription drug plan . . .

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).

Feb, 16 2023 — TrOOP or your total out-of-pocket cost is the total amount you will spend in a year on your formulary drugs before exiting the Coverage Gap (or Donut Hole) and entering the Catastrophic Coverage of yo . . .

Mar, 16 2023 — An HMO POS is a Health Maintenance Organization with a Point of Service Option. An HMO POS is a Medicare Advantage Plan that is a Health Maintenance Organization with a more flexible network allowi . . .

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 . . .