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Medicare, the federal program, helps cover health care costs for people over 65 (and under 65 with certain disabilities), and is divided into four parts:
Private companies that offer Part D coverage are allowed to design their own benefit plans, as long as the overall value of the plan is at least as good as the basic plan outlined in the 2003 Medicare Act. So, different plans offer different lists of medicines (called a formulary), and different costs. Beneficiaries should compare the different drug plans available in their area to find the one that best suits their needs.
The basic Part D plan generally meets the following criteria:
Some drugs are generally not covered by Medicare Part D, including:
How much you'll pay for Medicare drug coverage depends on which plan you choose. But in general, here's what you can expect to pay in 2018:
Costs and limits may change each year, and not all plans will work exactly this way.
Health-care legislation passed in 2010 gradually closes the prescription drug coverage gap, also called the "donut hole." In 2017, if you have spending in the coverage gap, you'll receive a 60 percent discount on covered brand-name drugs, and a 49 percent discount on covered generic drugs. Other changes will take effect in future years.
Extra help with Medicare drug plan costs is available to people who have limited income and resources. Medicare will pay all or most of the drug plan costs of those who qualify for help.
Medicare prescription drug coverage is available in two ways:
If you are in an HMO or PPO, you must receive drug coverage through that plan.
If you are currently enrolled in Medicare, you can enroll in Part D (or make changes to your Part D coverage) from October 15th through December 7th of each year (the Annual Election Period, also called the Annual Enrollment Period, or AEP). If you're new to Medicare, you have seven months to enroll in a drug plan (three months before, the month of, and three months after, becoming eligible for Medicare). If you qualify for Extra Help, you can enroll in a drug plan at any time during the year.
If the initial enrollment period is missed, you will be able to enroll (or dis-enroll, or change drug plans) during the Annual Election Period. However, a premium penalty will generally apply unless the reason you didn't join sooner was because you already had creditable prescription drug coverage that was at least as good as the coverage available through Medicare.
You will be unable to enroll, dis-enroll, or change drug plans during the Medicare Annual Enrollment Period (AEP), which is October 15 through December 7.
You can join or change plans during a Special Enrollment Period (SEP) in certain situations, including (but not limited to):
Medicare.org makes enrolling in Medicare Part D coverage simpler. Our licensed sales agents can answer any questions you have about the process. Contact us at (888) 815-3313 — TTY 711 to learn more today.
MULTIPLAN_GHHK3T9EN_AcceptedMedicare.org is a non-government site and is operated by HealthCompare Insurance Services, a licensed health insurance agency certified to sell Medicare products. It contains information about and access to insurance plans for Medicare beneficiaries, individuals soon eligible for Medicare and those advising on behalf of Medicare beneficiaries. Medicare.org is not endorsed by the Centers for Medicare & Medicaid Services (CMS), the Department of Health and Human Services (DHHS), or any other government agency.
If you're looking for the government's Medicare site, please navigate to www.medicare.gov.
HealthCompare Insurance Services, Inc. is a licensed and certified representative of Medicare Advantage HMO, PPO and PFFS organizations and Medicare Prescription Drug plans with a Medicare contract. Enrollment in any plan depends on contract renewal.
The purpose of this communication is the solicitation of insurance. Contact will be made by an insurance agent/producer or insurance company.
Limitations, copayments, and restrictions may apply. Benefits, premium and/or copayments/coinsurance may change on January 1, of each year.
The plans we represent do not discriminate on the basis of race, color, national origin, age, disability, or sex. To learn more about a plan’s nondiscrimination policy, please click on the carrier’s link below.
Blue Cross Blue Shield - Illinois
Blue Cross Blue Shield - Montana
Blue Cross Blue Shield - New Mexico
Blue Cross Blue Shield - Oklahoma
Blue Cross Blue Shield - Texas
Blue Shield of California
Capital Blue Cross
Cigna Health Spring
Premera Blue Cross
Scott & White
Vibra Health Plan
Last Revised 11/15/2017