1. You must have Part A and/or Part B of Medicare.
2. You must live in the plan’s service area.
When beginning the process, in most cases, you should enroll in Part D as soon as you are eligible. This enables you to avoid gaps in coverage and the late enrollment penalty. You aren’t forced to enroll in a drug plan, but even if you aren’t taking many prescription drugs, this will help you avoid the penalty for not enrolling.
It is also important to know that there are only certain dates when you can enroll. These include the Initial Enrollment Period, the Annual Election Period, Medicare Advantage Disenrollment Period, and Special Election Period.
Your initial enrollment period (IEP) starts 3 months before, includes the month of, and lasts for 3 months after your enrollment in Medicare. For example, you start Medicare A and B in August. Your IEP starts May 1st and ends November 30th. Enrolling during the first 3 months of the IEP means your Part D drug coverage starts on your Medicare effective date. If you wait to enroll until September, your coverage starts October 1. Enrollment in October means an effective date of November 1st.
Medicare drug plans have a list of covered drugs called a formulary. Plans cover these medications which include both generic and brand name drugs. The formulary includes at least 2 drugs in the most often prescribed categories. Plans choose which specific drugs they cover. If you need a medicine and it isn’t on your plan’s list, you may have to pay full price instead of a copayment or coinsurance. You may ask for an exception to cover a medication.
Medicare drug plans also require a monthly premium. You have options on how to pay this (deduction from Social Security, monthly checking or savings deduction, or pay directly with a coupon). Premiums in Indiana for 2020 range from the lowest at $13.20 to the highest at $74.70. The high cost plans often have a more extensive formulary and may have a lower deductible or none at all.
It’s important to do your homework before you enroll. This will help ensure that your medications are covered by the plan you choose and be sure a network pharmacy is close to you.
You can visit Medicare.gov or call 1-800-Medicare. For personalized help, call me at 260-747-0033.
This article is sponsored by Nancy Brickley, LUTCF, MBA who is the owner and licensed insurance agent of Nancy’s Insurance Service, located in Waynedale at 6110 Bluffton Rd. Ste. 118 Fort Wayne, IN 46809. If you have questions about this article or about Medicare Supplement Insurance, Life Insurance, Disability Income Insurance, Dental Insurance, Long-Term Care Insurance, Annuities; Cancer, Heart Attack & Stroke Insurance, Critical Illness Insurance and Small Business insurance Solutions, feel free to stop by her office or give Nancy a call at 260-747-0033.