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FAQs on General Medicare Part D (PDPs and MAPDs)



Browse the Medicare Part D "General Medicare Part D (PDPs and MAPDs)" FAQs
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Category: General Medicare Part D (PDPs and MAPDs)

Back To FAQ Home . Browse All (28) FAQs in Category

Most Viewed FAQs in Category


I am new to Medicare. Where can I get an overview of the Medicare Part D program?
In general, Medicare Part D prescription drug plans provide insurance coverage for your out-patient prescription drugs - so Part D plans work just like other types of insurance: (1) you usually pay a ...

How can I get financial "extra help" with my medication or Medicare Part D prescription drug costs?
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 and 7 pm and a ...

What is meant by the abbreviations: EA BA DS AE in the plan benefit type?
The Medicare Part D Benefit Types as shown in PDP-Facts our Part D Plan Statistics (National and State) are defined by the Center for Medicare and Medicaid Services (CMS) as follows:defined standard (...

Medicare Part D? What is it? How do I do to get it? Who pays for it? How do I enroll?
The Medicare Part D prescription drug program provides prescription drug coverage through either stand-alone Medicare prescription drug plan (PDPs) or Medicare Advantage plans that include prescriptio...

What are the CMS Medicare Part D prescription drug plan regions?
The Medicare Modernization Act mandated that the Centers for Medicare and Medicaid Services (CMS) establish geographic regions for the implementation of the Medicare Part D prescription drug plans (PD...

Which United States territories are covered by Medicare Part D prescription drug plans? Is there a way to see the Medicare Part D plans offered in these U.S. Territories?
There are five United States territories that are covered by the Medicare Part D program and offer stand-alone Medicare Part D prescription drug plans: American Samoa Guam the No...

What is Public Law No: 110-275 - Medicare Improvements for Patients and Providers Act of 2008 or MIPPA?
The  Medicare Improvements for Patients and Providers Act of 2008 or MIPPA was passed in July 2008 and amends a number of sections of the existing Medicare law or, in the words of Congress, the M...

What is Cost Sharing in a Medicare Part D or Medicare Advantage plan?
"Cost Sharing", according to the Centers for Medicare and Medicaid (CMS) is defined as: the amount you pay for health care and/or prescriptions.  This amount can include co-payments, coinsuranc...

What is a Demonstration/Pilot Program in Medicare Part D?
The  Demonstration/Pilot Program , according to the Centers for Medicare and Medicaid (CMS) is defined as: Special projects that test improvements in Medicare coverage, payment, and quality of c...

How will my American Indian or Alaska Native health program work with my Medicare prescription drug coverage?
Many Indian health pharmacies offer Medicare drug plans. You and your Indian health provider will benefit if you select one of these plans. You will continue to get prescriptions just as you do now. H...

. Newest FAQs in Category


I am new to Medicare. Where can I get an overview of the Medicare Part D program?
In general, Medicare Part D prescription drug plans provide insurance coverage for your out-patient prescription drugs - so Part D plans work just like other types of insurance: (1) you usually pay a ...

I am new to Medicare. Where can I get an overview of the Medicare Part D program?
In general, Medicare Part D prescription drug plans provide insurance coverage for your prescription drugs - just like other types of insurance. Your Medicare prescription drug coverage can be prov...

What is meant by the abbreviations: EA BA DS AE in the plan benefit type?
The Medicare Part D Benefit Types as shown in PDP-Facts our Part D Plan Statistics (National and State) are defined by the Center for Medicare and Medicaid Services (CMS) as follows:defined standard (...

Medicare Part D? What is it? How do I do to get it? Who pays for it? How do I enroll?
The Medicare Part D prescription drug program provides prescription drug coverage through either stand-alone Medicare prescription drug plan (PDPs) or Medicare Advantage plans that include prescriptio...

How can I get financial "extra help" with my medication or Medicare Part D prescription drug costs?
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 and 7 pm and a ...

Which United States territories are covered by Medicare Part D prescription drug plans? Is there a way to see the Medicare Part D plans offered in these U.S. Territories?
There are five United States territories that are covered by the Medicare Part D program and offer stand-alone Medicare Part D prescription drug plans: American Samoa Guam the No...

What is Public Law No: 110-275 - Medicare Improvements for Patients and Providers Act of 2008 or MIPPA?
The  Medicare Improvements for Patients and Providers Act of 2008 or MIPPA was passed in July 2008 and amends a number of sections of the existing Medicare law or, in the words of Congress, the M...

What are the CMS Medicare Part D prescription drug plan regions?
The Medicare Modernization Act mandated that the Centers for Medicare and Medicaid Services (CMS) establish geographic regions for the implementation of the Medicare Part D prescription drug plans (PD...

What is the Monthly Premium in Medicare Part D?
The  Monthly Premium, according to the Centers for Medicare and Medicaid (CMS) is defined as: The periodic payment to Medicare, an insurance company, or a health care plan for health care or pre...

Do I have to join a Medicare drug plan?
No.  Joining a Medicare drug plan is your choice.  However, if you don’t join a plan from October 15th through December 7th of each year, and you don’t currently have a drug...


Back To FAQ Home . Browse All (28) FAQs in Category




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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.
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  • The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan.
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  • 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.