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FAQs on Q&A of the Day

Browse the Most Viewed and Newest Medicare Part D FAQs
If you still have questions, please contact us through our Online Help Desk.

Category: Q&A of the Day

Most Viewed FAQs in Category
How will I choose between a stand-alone Medicare Part D prescription drug plan (PDP) and a Medicare Advantage plan that includes prescription drug coverage (MAPD)?
Medicare prescription drug coverage is available through either stand-alone Medicare Part D prescription drug plans (PDPs) or Medicare Advantage plans that include prescription drug coverage (MAPDs) . . .

What kind of discount can we expect in the Medicare Part D Donut Hole or Coverage Gap?
Starting back in the 2011 Medicare Part D plan year, a discount or co-insurance (cost-sharing) was introduced to reduce the cost of generic and brand-name prescription drugs purchased by non-LIS . . .

If I decide not to join any Medicare prescription drug plan, and I do not have any other prescription coverage, how long will I have to pay the late-enrollment premium penalty?
Probably forever.  The late-enrollment premium penalty is permanent for most people over 65 and you will pay the penalty as long as you are enrolled in a Medicare Part D prescription drug plan (o . . .

Is there really any difference between a Medicare Part D prescription drug plan and a Medicare Advantage plan?
Yes!  A stand-alone Medicare Part D prescription drug plan (or PDP) only provides out-patient prescription drug coverage. Alternatively, Medicare Advantage plans provide coverage for your . . .

Do Medicare Part D plans cover the shingles vaccine?
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).  However, coverage (a . . .

How do I report the death of a Medicare beneficiary?
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 cannot re . . .

What is the Initial Coverage Limit? Can the limit vary between Medicare Part D plan providers?
Your Initial Coverage Limit (or ICL) is the boundary between your Medicare Part D plan's Initial Coverage Phase and the Donut Hole or Coverage Gap.  The ICL is the total retail value of formulary . . .

When will Social Security begin deducting my Medicare plan premiums from my monthly Social Security check?
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 . . .

When I enroll in a new Medicare Part D prescription drug plan, do I need to disenroll from my old Medicare Part D plan or do I need to notify the current prescription drug plan about the change?
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 . . .

I didn't pay my plan premiums and was disenrolled from my Medicare Part D plan. What is the "good cause" that I must show to be reinstated in my plan?
First, if you receive a written notification that you have not paid your Medicare plan premium (or IRMAA payment), telephone your Medicare plan’s Member Services department immediately (the to . . .

Newest FAQs in Category
Is there a Special Enrollment Period for Medicare beneficiaries affected by a Major Disaster like a hurricane, typhoon, wildfire, flood, or earthquake?
Yes.  If you live in an area where the Federal Emergency Management Agency (FEMA) declared an emergency or major disaster, and you were not able to take advantage of an enrollment period (such as . . .

Do you have an online Formulary Browser that I can use to see the prescriptions covered by my Medicare Part D plan?
Yes.  We have our Formulary Browser online that includes every Medicare Part D and Medicare Advantage plan formulary or drug list and all formularies are formatted for alphabetical browsing.  . . .

What do I need to know about my new Medicare card?
The Centers for Medicare and Medicaid Services (CMS) is mailing new Medicare cards to all 57.7 million Medicare beneficiaries (starting back in April 2018) and will continue through April 2019*. Up . . .

Why are my medications costing more this year even though I didn't change Medicare Part D plans?
Medicare Part D prescription drug plans (PDPs and MAPDs) can change every year and even if you stayed with your same plan from 2018, there are a number of possible reasons why you may be paying more . . .

Can the cost of my prescriptions change while I am still in my Medicare Part D plan's Initial Coverage Phase?
Yes.  If your Medicare Part D prescription drug plan cost-sharing is based on a percentage of retail price (such as 25% co-insurance), you will find your coverage cost increases (or decreases) du . . .

What is Extra Help?
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 . . .

If I am paying a Part D late-enrollment penalty and then become eligible for Extra Help, am I still responsible for paying the penalty?
No.  You are not responsible for a late-enrollment penalty (LEP) if you are now eligible for the Medicare Part D Extra Help or Low-Income Subsidy (LIS) program.And remember, you automatically qua . . .

Can I be assessed an Income Related Monthly Adjustment Amount (IRMAA) if I am enrolled in my employer's Medicare Part D plan?
Yes.  If your annual income (MAGI) exceeds certain limits - and you are enrolled in an employer-sponsored Medicare Part D prescription drug plan (PDP) or Medicare Advantage plan with prescriptio . . .

Why am I no longer allowed to have my Medicare Part D premiums automatically deducted from my monthly Social Security check?
When you enrolled in your new Medicare Part D prescription drug plan you may have selected to have your monthly plan premiums automatically deducted from your Social Security check.  However, sin . . .

I learned that no Medicare Supplement Plan F can be sold after 2020. If I am already enrolled in a Plan F, will I be able to keep my Medigap Plan F beyond 2020?
Yes.  If you are enrolled in a Medicare Supplement Plan F before 2020, you will be able to keep your Medicare Supplement after 2020. But, as many financial advisors have stated, you may find t . . .


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Q&A of the Day
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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.