Senior Health Information and Insurance Education

Part D Coverage

What is Medicare Part D?

Part D plans are a way for seniors age 65 and older and people with disabilities on Medicare to cover the cost of prescription drugs.

How to qualify for Part D?

You must have or qualify for:
Signing up for Part D is optional. If you delay signing up for Part D without creditable coverage, you may accrue penalties. You will get an annual notice from your plan informing you if you have creditable coverage for Part D. If you have questions about the status contact your insurer.

When can I join?

  • If you're nearing age 65, you can join Part D during your Initial Enrollment Period.
  • If you already have Medicare, you can enroll in a Part D plan during Open Enrollment from October 15 through December 7 of each year.
    • During this time, you can change plans, drop plans or sign up.
  • There are several Special Enrollment Periods when you can enroll or change your plan if you meet the particular requirements.

Does this plan cover all of my prescriptions and work with my pharmacy?

Good question! Determining if a plan is a good fit for your situation is something that you should do right away when enrolling in a Part D plan for the first time. A comparison should also be done every year to ensure that you are always enrolled in a plan that covers all of your medications and works with your pharmacy. SHIINE recommends you do a plan comparison every year during Open Enrollment (October 15 - December 7) and is available to help you determine the plan that meets these very important needs:
Cost
  • Find out how much you'll have to pay in premiums, deductibles, copayments and coinsurance.
Coverage
  • Find out if any of your medications have restrictions or need prior authorization from your provider.
  • Make sure all of your medications are on the formulary of the plan you are considering.
Convenience
  • Find out if your plan works with your pharmacy or, if you prefer, if you can get your drugs through mail order.
  • Each plan covers different prescription drugs. Review each one carefully and take note of any restrictions to find the plan that best meets your needs.

How can I enroll?

You can enroll by:
  • Contacting SHIINE to help you do a plan comparison and assist you with your enrollment
  • Calling the plan directly
  • Calling 800-MEDICARE (800.633.4227) or
  • Going to Medicare.gov

 
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