Medicare Part-D is a federal prescription drug program for Medicare eligible participants. Plan premiums and coverage vary depending on where you live and the plan that you select.
Generally Part-D plans include generic, brand and preferred drugs up to $2,930 per year
Most plans will have co pays or co-insurance for a one or three month supply. Some plans include generic drugs through the "doughnut hole" which is between $2,930 and $4,700 in 2012. These numbers are subject to change each year as determined by The Centers For Medicare and Medicaid Services also referred to as CMS. Many brand drugs will be offered at a 50% discount through the doughnut hole or coverage gap.
It is important to review the insurance companies prescription drug formulary prior to selecting a plan to be sure that your drugs are covered. Each companies formulary may be different or cover certain Rx drugs on a different tier level which may affect your overall cost.
You may qualify for a Part-D subsidy program if you have a low annual income. There is a Federal low income subsidy available for thos who meet certain income criteria. You may apply by visiting the Social Security website at www.ssa.gov. Many states also have different programs which may help those who do not qualify for the Federal program. NY State has a program called EPIC which helps seniors with prescription drug costs and assistance getting through the "doughnut hole" if necessary. You may make changes in your Part-D plan annually between Nov. 15 and Dec. 31.
Enrollment for most beneficiaries is voluntary. The initial enrollment period takes place each October 15, through December 7. Potential beneficiaries who did not enroll by the December 7, deadline (or within 3 months after their initial eligibility date) will incurr a late enrollment penalty of 1% per month based on the National average cost of the premium until their enrollment.
Annual enrollment periods for Medicare Part D begin on October 15th of the prior plan year. The initial enrollment period for the second year of Medicare Part D started November 15, 2006. In its first year, beneficiaries eligible for both Medicaid and Medicare (dual eligible) were transferred from Medicaid prescription drug coverage to a Medicare Part D plan on January 1, 2006.
Hundreds of Medicare prescription drug plans are available, allowing participants to choose a plan that best meets their individual needs. Plans can choose to cover different drugs, or classes of drugs, at various co-pays, or choose not to cover some drugs although the Center for Medicare and Medicaid does require that all plans meet certain formulary requirements.
Medicare has made available an interactive online tool called the Prescription Drug Plan Finder that allows for comparison of drug availability and costs for all plans in a geographic area. The Prescription Drug Plan Finder can be used to perform a personalized or general search for plans; in either case, the tool allows one to enter a list of medications along with pharmacy preferences.
If you need assistance finding the correct plan to suit your needs please contact us and one of our representatives will help you.
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For Express Enrollment Fax Enrollment Form To 585-697-3048
The annual election period (AEP) for enrolling or changing Medicare plans is from November 15 to December 31 each year. You may make changes to an existing plan or enroll in a new plan during this time including, but not limited to, enrollment in a Part D prescription drug plan.
From January 1 to February 4 each year Medicare Enrollees may disenroll from their current plan and return to Original Medicare. During this period you may also choose and add a stand alone Part D prescription drug plan.
While we do not specifically endorse any one company or plan, we feel it is important to provide everyone with complete information to help them make an informed decision to find the best plan or company to fit individual needs.
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