Medicare Part D

Facts About Medicare Drug Coverage - Part D

•All individuals with Medicare are eligible to enroll in a Medicare

•Individuals must enroll in a plan when they first become eligible for Medicare or they
will be charged a penalty for enrolling late

•Coverage may be a stand alone plan (PDP) or included in a Medicare Advantage
plan (MAPD)

•Extra help paying drug plan costs is available to some people with limited income
and resources.  Applications and information are available  through the Social
Security Website www.ssa.gov and on the Medicare website www.medicare.gov

•Individuals who have coverage through a retirement plan or employer plan that is
considered “creditable coverage” may not have to sign up for Part D.  You should
check with your health plan administrator.

•All Medicare drug plans must offer at least the standard level of coverage.  The basic Medicare plan includes an annual deductible, 25% cost sharing until you reach the first level of total drug costs, 100% cost sharing (coverage gap) until you reach the next level of total out-of-pocket costs, then 5% or a small copayment  once you reach what Medicare calls the Catastropic level of out-of-pocket costs.  Deductible and cost sharing amounts change every year and plans usually announce their new numbers in November just before the annual plan enrollment period.

•Deductibles and cost sharing totals are annual and are reset each January.

•General enrollment for Medicare Part D Plans is November 15-December 31 each year.  You can change plans during this period and your new coverage begins in January of the following year.

•Once you have enrolled in Part D, each year your plan will send enrollment documents.  If you want to continue in that plan you will typically not need to take any action.  If you want to change, you must do it before the end of open enrollment period in December.

•BE SURE YOU READ YOUR ANNUAL ENROLLEMENT INFORMATION CAREFULLY TO DETERMINE IF YOU ARE STILL IN THE BEST PLAN OR IF THERE HAVE BEEN CHANGES IN YOUR PLAN BENEFITS.

•TO COMPARE PLANS YOU CAN GO TO www.medicare.gov