How to Get Medicare Prescription Drug Coverage
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Traditionally, drug prescription covers are not included in original Medicare Parts A and B. This can mean that you may incur expensive drug costs especially when under long-term drug care. You can avoid such expenses by taking a prescription drug coverage plan. It helps you save money and have less stress regardless of your health condition.
You have to enroll for prescription drug coverage as soon as you are eligible. Failure to do that and you may have to pay a late enrollment penalty. So, how do you enroll for prescription drug coverage with Medicare? There are two ways:
Medicare Prescription Drug (Part D) Plan
With this option, you enroll in a stand-alone Medicare prescription drug (PDP) plan. It works alongside your primary Medicare plan and any other additional Medicare benefits you enjoy.
Medicare Advantage (Part C) Plan
It is also known as the MAPD plan and it allows you to consolidate all your Medicare plans. It is applicable if you originally had Part A and Part B Plans. It ensures the convenience of getting your prescription drug coverage, hospital, doctor, and other benefits under one plan.
Some of the major questions you might have about prescription drug coverage with Medicare include:
How to Enroll
Enrolling for the program is easy. Here is an outline of the registration procedure:
Call Medicare at 800-633-4227 or the toll-free Medicare number 877-486-2048 if you are hard of hearing and rely on TTY.
Online, go to http://www.medicare.gov/ and use the plan finder to compare the two main plans. Click the ‘Enroll’ button on your preferred plan to get and fill an application form.
Alternatively, contact the plan you prefer at its website or the phone number offered on its brochure. You can also get the plan’s phone number on Medicare’s website.
When to Enroll
If enrolling for the first time, you have the following enrollment periods to choose from:
Initial Enrollment Period (IEP). If you are not in Medicare and have no other creditable drug coverage, you have a seven-month enrollment window. This specifically means three months before and after your 65th birthday.
The same window applies to your 25th social security disbursement if you are younger with disabilities. You can also use the window if you turned 65 in prison or abroad.
Special Enrollment Period (SEP). It is applicable in special conditions like when you lose your creditable coverage.
Annual Open Enrollment Period (OEP). It runs from15th October to 7th December of each year.
What Questions Can You Expect to Be Asked?
Regardless of your enrollment method, you have to answer a couple of basic questions. They include:
Your Main Address: The address for your primary residence and which is included in your tax form and driver’s license. This ensures that you only apply for one prescription drug coverage. You should provide the address that is within the service area of the plan you opt for.
Your Present or past Drug Coverage: This ensures that all your other benefits are coordinated with Part D. It also ensures that you confirm to accept any consequences of joining Part D. This is important if the coverage may affect your other Medicare plans adversely.
How would you prefer to pay for your Premiums? You can have the plan bill you directly or have the premiums deducted from your social security check automatically. Alternatively, you can choose to have your bank wire the funds to the plan automatically. Once you make a selection, you have to stick with it for the rest of the year.
Can You be Turned Down?
Only under a few conditions such as ineligibility for Medicare or provision of an incorrect residential address. The plan has to explain why you were turned down.
How Will You Know If Your Enrollment Has Been Accepted or Denied?
10 calendar days after your application, the plan has to send you any of the following:
Acknowledgment of your submitted application, its copy, and the plan’s details
Request for more details to process your application that you should offer within 30 days
Notice of your denial which should state why you have been denied
What If You Enroll for One Plan and Then Find Another One You Prefer More?
You can switch your plan during the Open Enrollment Period. Any need to terminate the plan before the current plan is over will turn futile.
When is the Latest you can enroll?
Technically up to the last day of the enrollment period. However, to get your prescriptions on the first day of coverage, enroll two weeks in advance.
When Will Your Drug Coverage Start?
During the first month after your enrollment. However, if you switch plans during the Open Enrollment period, you have to wait until 1st January.
Bottom Line
You should only choose a plan that you think suits your needs properly. This means that you have to be on the lookout for commission-hungry salespeople. Always call the Medicare helpline, 800-633-4227, when in doubt or visit the Medicare website for more details.