The puzzle to Medicare is almost over for some. There are many parts of Medicare coverage and different things that have to be decided upon. When people think of Medicare, they think it's an all-inclusive package. It is very important for people to understand the different components, why they need it and what it does for them. As people gain more knowledge, they are able to understand the changes as they come and what they are entitled to.
What is Medicare Part D?
Medicare Part D gives those that have Medicare prescription drug coverage. This is a plan that will help people pay for the cost of the prescription drugs that their doctors may prescribe.
Medicare Part D is not the same as Medicare Part A and B. This is a prescription drug plan that is administered by an independent insurance company, not Medicare or Social Security. These insurance companies have partnered with Medicare to provide those with Medicare benefits access to lower costing medications they need.
How do I get Medicare Part D?
Medicare Part D is available to those that have Medicare Part A or B. As long as they have one or both of those insurances, they are eligible to get a prescription drug plan.
There are different ways to enroll into a prescription drug plan. Those that are new to Medicare normally begin to receive a large amount of mail from different insurance providers about Medicare drug plans. When eligible participants receive this information, they can call the company directly to get answers to their questions and enroll with them. Eligible Medicare participants can call Medicare to enroll into a plan as well as apply online or with a paper application.
When do I enroll into Medicare Part D?
There are normally 3 main times that an eligible person can enroll into a prescription drug plan. These times will depend on each individual's situation and can vary from individual to individual.
The most common time to enroll into a prescription drug plan is an initial enrollment period or IEP. This time occurs when they are first eligible for their Medicare benefits. Some of these people have just turned 65 years old, have just been granted their Medicare coverage due to a disability or many other things. In most cases, people that have just turned 65 have a rolling 7 month period to enter into a prescription drug plan without a penalty. They may enroll into a prescription drug plan 3 months before their 65th birthday, the month of their birthday or 3 months after their 65th birthday.
Another popular time that people enroll into a prescription drug plan is during the annual enrollment period or AEP. This happens each year from October 15 to December 7. AEP is a time of the year that people can change from their existing prescription drug plan provider to a new one for any reason. Once a person starts a prescription drug plan, they sign a contract to stay with that provider for one full calendar year. If for any reason they decide they would like to change their provider, the time to do it is during AEP.
There are some situations that don't fit the circumstances of IEP or AEP enrollments. There may be some situations that qualify for enrollment into a prescription drug plans and people can do so during a special enrollment period, SEP. There are times that people will move into a new state, their plan is no longer being offered because of a situation within the company and Medicare, loss of credible coverage or many other things. When these special circumstances arise, it is best that people call their prescription drug plan provider or Medicare to have their questions answered.
I don't have any prescriptions so I am not enrolling.
There are many people that feel that they shouldn't have to enroll into a prescription drug plan if they don't have any prescriptions to take. Enrolling into a prescription drug plan is optional but there are penalties for not enrolling into a prescription drug plan when they are first eligible to do so. If people choose not to enroll in any prescription drug plans after their Medicare begins, the premiums they will pay for their prescription drug plan will be increased by a late enrollment penalty.
When people are fined a late enrollment penalty or LEP, they have to pay an additional amount each month when they pay their premiums for the life of their Medicare Part D coverage. This penalty is calculated by considering the national average of the prescription drug plans for that year and for each month that a person isn't enrolled in a prescription drug plan; they have to pay an additional 1% for each month they aren't enrolled into a plan. These fees are calculated by Medicare and are communicated to the insurance provider when a person becomes enrolled into a plan.
When a person has been assessed a LEP, there is a notification that is sent to the participant. If the fee is inaccurate, there is a form that can be mailed back to the insurance company for reconsideration. It is important to respond to a fee assessment if it is not accurate because each year, the fee can increase or decrease, depending on the national average of a Part D plan.
Once a person has enrolled into a prescription drug plan, there are many things that they will be sent. They will be sent a formulary so they will know the particulars of the medications their plan covers, a coverage guide and other information so they know what their plan will do for them. As people have questions about their prescription drug plans, they should call their Medicare prescription drug plan provider or even Medicare. This type of insurance is an important part of anyone's medical care and if there are any questions, they need to be asked until there is a clear understanding.