Medicare Part D questions and answers
Q. What is the Medicare Prescription Drug Plan?
A. The Medicare program offers prescription drug. This benefit is known as the Medicare Prescription Drug Plan or Medicare Part D.
Q. Is the Medicare Prescription Drug Plan the same as Medicare Part D?
A. Yes. The Medicare Prescription Drug Plan is commonly referred to as Medicare Part D.
Q. What are the important dates to keep in mind?
A. October 15 was the first day to enroll in a Medicare Part D plan. Enrollment continues through December 7.
January 1 is the first day Medicare prescription drug coverage can be used (if you enrolled prior to December 7 of the previous year).
Q. What do I do if I am satisfied with my current Medicare D plan and want to continue receiving coverage from that plan?
A. You do not have to do anything if you want to continue using the same Medicare D drug plan that you currently have. Your coverage will continue from that plan provider.
Q. What if I want to change to a new Medicare D plan?
A. If you are going to make a change to your current coverage, then you must enroll with a new Medicare D plan. If you enroll by December 7 it helps to ensure that you can get the prescriptions you need on January 1 of the following year. The enrollment process can be completed on the Medicare Web site. www.medicare.gov
Q. What if my current Medicare D plan is no longer available?
A. In those cases where a Medicare D plan is no longer participating in Part D, the plan must notify you and provide information on alternative plans that are available. You will receive a letter from your plan prior to open enrollment.
Q. Who is eligible for the Medicare Prescription Drug Plan?
A. Anyone who receives health care coverage through the Medicare program is eligible for prescription drugs. This is a voluntary benefit. You may choose not to sign up for Medicare's prescription drug coverage.
Q. How do I determine if I should sign up for a Medicare Part D plan?
A. Aurora Pharmacy has some basic tools that can assist you in the process. The tool kit helps you to estimate what your benefits may be under the Medicare D program. In order to determine the specific plan that may be best for your situation, you will have to utilize the Medicare internet site. www.medicare.gov
Q. What will prescriptions cost?
A. Each drug plan can set its own prices. Your prescription costs will depend on the plan you choose, the type of medicine you need, and your income level. Many Medicare beneficiaries will have to pay a monthly premium, a deductible and other out-of-pocket costs. Medicare beneficiaries with low income and few assets may be eligible for extra help with the out-of-pocket costs associated with the drug plan. Medicare beneficiaries who have Medicaid coverage may also be eligible for assistance with their out-of-pocket costs.
Q. Who will provide coverage for the Medicare Prescription Drug Plan?
A. Drug coverage will be offered by private drug plans approved by the federal government. The list of those drug plans available in Wisconsin is available at the Aurora Pharmacy website.
Q. What drugs will be covered by the Medicare Prescription Drug Plan?
A. There will be a choice of Medicare drug plans in your area. Your drug coverage will depend on which plan you choose. The government does not require every plan to offer the same drugs. Each plan can design its own list of coverage drugs – commonly called the drug formulary. Medicare drug plans have been required to include those types of drugs commonly prescribed to elderly and disabled Medicare beneficiaries.
Q. Will all plans be available through my local pharmacy?
A. Aurora Pharmacy will accept all Medicare D plans that have been approved in Wisconsin.
Q. How can I enroll in a Medicare Prescription Drug Plan?
A. The enrollment process can be completed through Medicare's Web site. That tool is available at www.medicare.gov
Q. What if I have other questions about Medicare Prescription Drug Plan eligibility or benefits?
A. You can check with your Aurora pharmacist or call 1-800-MEDICARE (1-800-633-4227) Another option is to visit www.medicare.gov on the internet.
Q. Is Medicare Part D available only to people with limited incomes?
A. No. The monthly premium for an individual is related to income. A person whose income falls within a certain level will not have to pay a monthly premium. If your income is at a higher level, then expect to pay a monthly premium.
Q. Can SeniorCare be used as a secondary payor?
A. Yes, your Medicare Plan D would be billed first and then SeniorCare.
Q. I have seen references to creditable coverage. If I am enrolled in a prescription drug program through an employer (or SeniorCare) and maintain that coverage, will I face
an enrollment penalty if my coverage ends after the initial enrollment period for Medicare D?
A. Creditable coverage is coverage that is as good or better than Medicare Part D basic coverage. The plan that you currently have should provide this documentation. If you choose to stay with the current "creditable" plan and then later lose that coverage, you will need to provide proof that the previous plan was “creditable” when you enroll in a Medicare Part D plan to avoid the premium penalty. Medicare has very strict restrictions that prohibit a pharmacy from telling a customer if their current coverage is creditable. You should contact your current plan to find out if it is creditable.
Note that most Medigap plans are not creditable coverage. They have sent letters to enrollees stating this. Many enrollees may not understand that if they stick with the Medigap plan and do not enroll with Medicare D, and then enroll in a Medicare D plan later they will be charged the late enrollment penalty.
Q. If I decide to continue in SeniorCare, is that considered a "qualified prescription drug plan" so that if SeniorCare is terminated at some later point in time and I enroll
in Medicare part D, I will not be subject to the additional fee of 1% per month?
A.The information we have received from SeniorCare is that the plan is considered "creditable coverage" and you will not face an enrollment penalty.