FAQs on Living with Your Medicare Part D Plan

FAQs on Living with Your Medicare Part D Plan

Browse the Most Viewed and Newest Medicare Part D FAQs
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•	I wish to drop my Medicare Part D prescription drug plan coverage - What should I do? In general, you can only drop, disenroll, or cancel your Medicare Part D plan or Medicare Advantage plan coverage during the annual Open Enrollment Period (AEP) -- that runs each year from Octob . . .
•	What is the BIN, PCN, and RxGROUP number for my Medicare Part D prescription drug plan? 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 . . .
•	My father has lost his Medicare Prescription Drug Plan card. How do I get him a replacement ID card? Please have your father contact his Medicare prescription drug plan Member Services department (Medicare Part D or Medicare Advantage plan) directly to receive his replacement Member ID card.The toll- . . .
•	If I do not want to change my current Medicare plan during the Annual Enrollment Period, what should I do? 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 . . .
•	How much do I have to pay for generics in the donut hole in 2011, 2012, 2013,2014, 2015, etc. until it reaches 25% Even if your Medicare Part D plan has no coverage in the gap, starting in 2011, you receive a discount on your medications while in the coverage gap. For generic drugs, you would pay the following p . . .
•	Are both Fioricet with Codeine and plain Fioricet covered under any Medicare Part D prescription drug plan? Yes. A few 2018 stand-alone Medicare Part D plans and Medicare Advantage plans cover both Fioricet with Codeine and Fioricet without Codeine. For example, the 2018 Aetna Medicare Rx Sele . . .
•	How does the premium grace period work for Medicare Part D plans? 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 . . .
•	I enrolled last month and I have not received my Member plan card and now am out of my prescriptions - how do I get my card? 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 . . .
•	Is Xanex or Alprazolam allowed to be covered by Medicare Part D prescription drug plans? 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 . . .
•	This year my Medicare Part D plan told me that Clonazepam is not covered under my Part D plan. However, my mother has the exact same Part D plan as I do and the Part D provider covers this medication for her. 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 . . .

•	How do I get a refund for over-paid Medicare Part D premiums and co-payments? The Centers for Medicare and Medicaid Services (CMS) provides a "tip sheet" explaining how Medicare beneficiaries can receive a refund for their overpaid Medicare drug plan copayment and/or premiu . . .
•	Am I required to use my Medicare Part D plan when buying my prescriptions? 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 . . .
•	Already enrolled? What to do while waiting for your new Medicare Part D prescription drug plan Member ID card. 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 . . .
•	Will my Medicare Part D plan reimburse me if I purchase a formulary medication from a source outside the United States? Only in very limited situations. In 2016, the Centers for Medicare and Medicaid Services (CMS) updated their Prescription Drug Manual and added some guidance for the exceptional circumstanc . . .
•	I just joined a Medicare Part D plan in May. Will my new plan year start a year from now or January 1st of next year? Your new Medicare Part D plan year will begin on January 1st of each year.The Medicare Part D plan year runs from January 1st through December 31st of each year, so the plan year runs for a calendar y . . .
•	Does my Medicare Part D plan or Medicare Advantage plan also provide Silver Sneakers coverage? 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 . . .
•	I cannot find a phone number for contact purposes regarding a claim denial. 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 have already done that and are looking f . . .
•	Is Xanex or Alprazolam allowed to be covered by Medicare Part D prescription drug plans? 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 . . .
•	My husband has already reached the "donut hole" this year. Will his coverage start over on January 1st or will he continue to be in the "donut hole"? On January 1st, your husband's Medicare Part D plan will start over.If his Medicare Part D plan has an initial deductible, he will need to pay the initial deductible before his Initial Cover . . .
•	I wanted to purchase a few medications without using my Medicare Part D plan and my local pharmacy said that I had to use my Medicare Part D card when purchasing my prescriptions. The pharmacy said it was illegal not to use my Medicare Part D plan. 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 . . .