Medicare Publication on closing the donut hole 11493it will close sooner  

Our webpage on the donut hole 
Donut Hole - Coverage Gap

Steve’s Video on Donut Hole circa 2014?

Medicare Part D Rx Prescriptions

Part D Rx is practically mandatory.  If you don’t have coverage when you are supposed to your premium is increased  when you eventually do.

Many Part D  plans cover the gap or donut hole, (Brand Name 50% Discount) just be sure to read the illustrations, brochures and drug formularies, on or through our website.

Medicare Advantage plans generally include prescription drug coverage, including both brand-name and generic at participating pharmacies in your area.

Check out your guide to Medicare Rx Coverage #11109,  Medicare & You #10050 or these companies webpages for more details, coverage and premiums.  See also Medicare & You in the side panel

Blue Cross 

 AARP – Part D Rx

♦  Blue Shield

The Annual Open Enrollment (AEP) is from October 15th to December 7 and then your coverage will begin January 1 (Medicare FAQ.)  If you’ve just turned 65, you’re eligible now!email us or review this website for details.  If you have a Medicare Advantage Plan, with or without Rx coverage and you sign up for Part D coverage, you WILL be dropped from the Medicare Advantage plan! cahealthadvocates.org  You may sign up right through our site, for Part D Rx, a Medicare Advantage Plan or a Medi-Gap – Supplement Plan.

FAQ’s

Is my Rx on the approved list – formulary, how do I get an exception?

Appeals & Grievances

2 Ways to Get Medicare Drug Coverage How does a Prescription Drug Plan work with a Medicare Advantage Plan?  4 pages 

Publication # 11135 When Can You Join a Medicare Drug Plan?

Can’t afford Rx premiums or co pays?  Low Income click here 

Part D Extra Help #10525  

Understanding Part D Extra Help # 10508

How to Join a Medicare Drug Plan 
of course you can just email us [email protected]

How to Switch Your Medicare Drug

Plan How to Drop Your Medicare Drug

Plan What You Pay for Medicare Drug Coverage

Costs in the Part D Coverage Gap

What Is the Part D Late Enrollment Penalty?

How much is the Part D Penalty?

What Part D Plans Cover

Drug Plan Coverage Rules

Fill a Prescription Before You Get Your Plan Card

How Other Insurance & Programs Work With Part D

MTM Medication Therapy Management Programs for Complex Health Needs – Humana MTM program elements include:

  • Comprehensive reviews of medications used on an annual basis;
  • Quarterly medication reviews;
  • Identification of medication related problems;
  • Prescriber and beneficiary interventions to promote coordinated care; and
  • Standardized action plans and summaries.

Blue Cross

cms.gov/Prescription-Drug-Coverage/).

medicare.gov

medicare.gov/find-a-plan/questions

medicare.gov Part D Index

More FAQ’s Medicare Site

 

Medicare and You 2020 #10050  
Everything you want to know 

Medicare and you

Different Parts of Medicare 

A = Hospital
B = Doctor Visits - Out Patient
C = Medicare Advantage or Medi Gap
D = Part D Rx

Video

Understanding your Medicare Choices
Medi Gap vs Medicare Advantage

Topics

How to sign up for Parts A & B
Is  your test, service, or item covered?
Original Medicare Parts A & B
Medicare Advantage Plans & Part D Rx
Supplement Insurance (Medigap)
Low Income Help  LIS
Definitions


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5 comments on “Part D Rx Prescriptions

    • You can pay your premium by:

      ■■Signing up to have your plan deduct it from your checking or savings account.
      ■■Charging it to a credit or debit card.
      ■■Having your plan bill you each month directly. Some plans bill in advance for next month’s coverage. Send your payment to the plan—not to Medicare. Contact your plan for their payment address.
      ■■Having funds withheld from your Social Security payment.

      Contact your plan—not Social Security—to ask for this payment option. It may take up to 3 months to start, and it’s likely the first 3 months of premiums will be collected at one time. Publication 11109 Guide to Part D

  1. I know that if I get a Medi Gap plan, I can buy Part D Rx and that if I get a Medicare Advantage with Part D MA-PD I can’t get extra coverage to cover Rx, what are the other restrictions on what plans go with Part D and which ones don’t?

    • Yeah, it’s a confusing question as so much of the questions and plans do not apply to California, but yet when we do our AHIP annual certification, they ask a ton of questions on it. IMHO especially annoying is the AHIP material doesn’t give citations and isn’t “official” plus it’s copyrighted… and password protected. I wish they training just used Official brochures that we could use with the public.

      Here’s the Q & A from an official brochure on Part D Rx This is the 2018 revision, so beyond 2020 the page #’s might be different.

      Section 4: Your Coverage Choices

      Get help with drug coverage decisions (of course you can email us [email protected] or leave your question below too) What else do I need to think about before I decide to get Medicare drug coverage?

      I have only Part A and/or Part B and no drug coverage I have Medicare and a Medicare Supplement Insurance (Medigap) policy without drug coverage
      ” Medicare Supplement Insurance (Medigap) policy with drug coverage
      ” get drug coverage from a current or former employer or union
      ” Federal Employee Health Benefits (FEHB) plan
      ” TRICARE or benefits from the Department of Veterans Affairs (VA) that include drug coverage I have a Medicare health plan (MA Medicare Advantage) without drug coverage
      I have a Medicare health plan with drug coverage MA PDI have Medicare and Medicaid Medi-Cal
      … get Supplemental Security Income (SSI) benefits or belong to a Medicare Savings Program
      … and live in a nursing home or other institution
      … and benefits through Programs of All-inclusive Care for the Elderly (PACE)
      … and get help from my State Pharmacy Assistance Program (SPAP) paying drug costs
      I get help from an AIDS Drug Assistance Program (ADAP)
      I have Medicare and get drug coverage from the Indian Health Service, Tribe or Tribal Health Organization, or UrbanIndian Health Program

      Official Medicare Brochure # 11109 Prescriptions

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