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Q1Medicare.com - Latest Medicare News

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2018 Federal Poverty Level Guidelines (FPL): 2018 LIS Qualifications and Benefits
The 2018 Federal Poverty Level (FPL) Guidelines determine the income level requirements for people applying for the Medicare Part D Low Income Subsidy (LIS) program, also known as the "Extra Help" pro ...

What does the letter after my Medicare number mean?
March 2018 Update - Medicare Cards are Changing - New Card, Same BenefitsThe Centers for Medicare and Medicaid Services (CMS) is mailing new Medicare cards starting April 2018 and continuing through A ...

Understanding the 2018 Medicare Part D Coverage Gap or Donut Hole
The Donut Hole or Coverage Gap is a term used to describe a gap or pause in your Medicare Part D prescription drug plan or Medicare Advantage plan coverage where, prior to 2011, you were 100% respon ...

2017 Federal Poverty Level Guidelines (FPL): 2017-2018 LIS Qualifications and Benefits
Note: The 2018 Federal Poverty Level Guidelines (FPL): 2018 LIS Qualifications and Benefits are now available. The 2017 Federal Poverty Level (FPL) Guidelines determine the income level requirement ...

2018 State Low-Income Subsidy Benchmark Premium Amounts - with a comparison of benchmark changes since 2006
Update   See: 2019 State Low-Income Subsidy Benchmark Premium Amounts - with a comparison of benchmark changes since 2006 at https://Q1News.com/703.html. The Centers for Medicare and Medicai ...

2018 IRMAA: 35% to 58% Medicare Part D IRMAA payment increases for individual earning incomes between $133,500 - $214,000 and couples earning $267,000 - $428,000.
Since 2011, people with Medicare who earn over $85,000 have been paying an additional monthly premium or Income-Related Monthly Adjustment Amount (IRMAA) for their Medicare Part D prescription drug p ...

SilverScript Medicare Part D Pharmacy and Formulary Search
Question: What drug stores accept the SilverScript Medicare Part D prescription drug plans? Most Medicare Part D plans are accepted by over 50,000+ pharmacies across the country. However, if you ...

Does Medicare cover Vitamin B-12 injections (B-12 shots)?
Medicare Part D prescription drug plans expressly excludes coverage for vitamins - although some Medicare plans do cover "excluded" drugs such as B-12 vitamin injections as "Bonus" or Supplemental dru ...

Medicare Advantage plan and Medicare Part D prescription drug plan Special Enrollment Periods(SEP)
In certain situations, people with Medicare may be eligible for a Special Enrollment Period (SEP) allowing them to join a Medicare Advantage plan or Medicare Part D prescription drug plan , or switch ...

WellCare Medicare Plan 2017 Medicare Pharmacy and Healthcare Provider Search Tools
You can find the WellCare Medicare Part D (PDP) pharmacy search and Medicare Advantage plan provider search tool at:  https://www.wellcare.com/Find-a-Provider#/Search. You can also start at:(1)&n ...

Latest News
Is the 2018 Medicare Part D plan information already available this summer?
No.  Next year's Medicare Part D and Medicare Advantage plan information will not be officially released until October 1st.If you are currently enrolled in a 2018 Medicare Part D or Medicare Ad ...

2019 Medicare Part D Late-Enrollment Penalties will decrease by 5.23% - But maximum penalties can reach $601 per year.
The average monthly 2019 Medicare Part D base premium used to calculate the late-enrollment penalty will decrease to $33.19, a 5.23% decrease from the 2018 base premium of  $35.02.  You ...

2019 IRMAA: 5% decrease in Medicare Part D IRMAA for individual earning incomes between $85,000 - $500,000 and couples earning $170,000 - $750,000.
Since 2011, people with Medicare who earn over $85,000 have been paying an additional monthly premium or Income-Related Monthly Adjustment Amount (IRMAA) for their Medicare Part D prescription drug p ...

2018 CMS Press Release: "Medicare Part D premiums continue to decline in 2019"
The Centers for Medicare and Medicaid Services (CMS) announced today that, "for the second year in a row", the average basic monthly Medicare Part D premium is expected to decrease slightly.Based on t ...

2019 State Low-Income Subsidy Benchmark Premium Amounts - with a comparison of benchmark changes since 2006
The Centers for Medicare and Medicaid Services (CMS) released the 2019 low-income premium subsidy amounts (or Benchmark) for Medicare Part D plans on July 31, 2018, and in 2019, thirteen (13) regions ...

Calculating the cost of a formulary drug with a $10,000 retail price using Straddle Claim logic.
If you purchase an expensive prescription medication, such as Zytiga ® (that has a retail cost of around $10,000), using your 2018 Medicare Part D plan, the cost of the first drug purchase would ...

July 2018 Drug List Updates: Nine new generic drugs added to many Medicare Part D plan formularies.
As you may know, Medicare Part D prescription drug plans are allowed to update their plan formularies or drug lists throughout the plan year and the July 2018 Medicare Part D formulary updates incl ...

July 2018 Formulary Changes to the Top Medicare Drugs
The July, 2018 Medicare Part D plan formulary (or drug list) data included 81 new drug codes or NDCs representing 58 different medications. The NDC uniquely identifies a particular manufacturer, dr ...

July 2018 Formularies Updates: Fifty-Eight (58) Medications Added to Medicare Plan Drug Lists
The July, 2018 Medicare Part D plan formulary data (or drug lists) includes the addition of 81 new National Drug Codes (NDCs) to the Medicare Part D program.  These NDCs represent 58 different dr ...

June 2018 summary of the new medications added to Medicare Part D plan formularies (drug lists)
The June, 2018 Medicare Part D plan formulary data (or drug lists) includes the addition of 52 new National Drug Codes (NDCs) to the Medicare Part D program.  These NDCs represent 33 different dr ...




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Tips & Disclaimers
  • The Medicare Advantage and Medicare Part D prescription drug plan data on our site comes directly from Medicare and is subject to change.
  • Medicare has neither reviewed nor endorsed the information on our site.
  • We provide our Q1Medicare.com site for educational purposes and strive to present unbiased and accurate information. However, Q1Medicare is not intended as a substitute for your lawyer, doctor, healthcare provider, financial advisor, or pharmacist. For more information on your Medicare coverage, please be sure to seek legal, medical, pharmaceutical, or financial advice from a licensed professional or telephone Medicare at 1-800-633-4227.
  • We are an independent education, research, and technology company. We are not affiliated with any Medicare plan, plan carrier, healthcare provider, or insurance company. We are not compensated for Medicare plan enrollments. We do not sell leads or share your personal information.
  • Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. Our PDP-Compare.com and MA-Compare.com provide highlights of annual plan benefit changes.
  • The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan.
  • Limitations, copayments, and restrictions may apply.
  • We make every effort to show all available Medicare Part D or Medicare Advantage plans in your service area. However, since our data is provided by Medicare, it is possible that this may not be a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.
  • When enrolling in a Medicare Advantage plan, you must continue to pay your Medicare Part B premium.
  • Medicare beneficiaries with higher incomes may be required to pay both a Medicare Part B and Medicare Part D Income Related Monthly Adjustment Amount (IRMAA). Read more on IRMAA.
  • Medicare Advantage plans that include prescription drug coverage (MAPDs) are considered Medicare Part D plans and members with higher incomes may be subject to the Medicare Part D Income Related Monthly Adjustment Amount (IRMAA), just as members in stand-alone Part D plans. In certain situations, you can appeal IRMAA.
  • You must be enrolled in both Medicare Part A and Part B to enroll in a Medicare Advantage plan. Members may enroll in a Medicare Advantage plan only during specific times of the year. Contact the Medicare plan for more information.
  • If you are enrolled in a Medicare plan with Part D prescription drug coverage, you may be eligible for financial Extra Help to assist with the payment of your prescription drug premiums and drug purchases. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or your state Medicaid Office.
  • Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next.
  • A Medicare Advantage Private Fee-for-Service plan (PFFS) is not a Medicare supplement plan. Providers who do not contract with the plan are not required to see you except in an emergency.
  • Disclaimer for Institutional Special Needs Plan (SNP): This plan is available to anyone with Medicare who meets the Skilled Nursing Facility (SNF) level of care and resides in a nursing home.
  • Disclaimer for Dual Eligible (Medicare/Medicaid) Special Needs Plan (SNP): This plan is available to anyone who has both Medical Assistance from the State and Medicare. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.
  • Disclaimer for Chronic Condition Special Needs Plan (SNP): This plan is available to anyone with Medicare who has been diagnosed with the plan specific Chronic Condition.
  • Medicare MSA Plans combine a high deductible Medicare Advantage Plan and a trust or custodial savings account (as defined and/or approved by the IRS). The plan deposits money from Medicare into the account. You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins.
  • Medicare MSA Plans do not cover prescription drugs. If you join a Medicare MSA Plan, you can also join any separate (stand-alone) Medicare Part D prescription drug plan
  • There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. Those who disenroll during the calendar year will owe a portion of the account deposit back to the plan. Contact the plan provider for additional information.
  • Medicare beneficiaries may enroll through the CMS Medicare Online Enrollment Center located at www.medicare.gov.
  • Medicare beneficiaries can file a complaint with the Centers for Medicare & Medicaid Services by calling 1-800-MEDICARE 24 hours a day/7 days or using the medicare.gov site. Beneficiaries can appoint a representative by submitting CMS Form-1696.