Senior News
Medicare offers prescription drug coverage, more commonly known as Medicare Part D, to everyone with Medicare. To get Medicare’s prescription drug coverage, you must join a plan that is approved by Medicare. There are currently 22 plans available in Montana from which to choose.
There are various times you can sign up for your Part D coverage. You can sign up during the Initial Enrollment Period when you first become eligible for Medicare. You have the same seven-month IEP for Part D as for Parts A & B. There are also several life events that will open a Special Enrollment Period and allow you to join, switch or drop your current plan. Some examples of those events are moving out of the plans service area, moving to a nursing home or losing “creditable” coverage from an employer.
If you are going to continue working and have employer- sponsored health care that also covers your prescription drugs, you can delay enrolling in a Part D plan until that coverage ends. Once your creditable working coverage ends, you will have a 63-day SEP.
There is also an Open Enrollment Period every year from Oct. 15, through Dec. 7. During this time, you can review what your current plan will look like in the coming year and change your plan if needed. Any changes made during the annual Open Enrollment Period will start Jan. 1, of the new year.
It’s important to remember that if you don’t enroll in a Part D plan when you are first eligible, even if you currently take no prescription drugs, unless you have “creditable coverage,” you will be assessed a penalty when you do enroll. This penalty is based on the number of months that you went without coverage and you will pay the penalty for as long as you have a Part D plan.
The actual costs for your plan will vary depending on which plan you choose, the pharmacy you select and the prescriptions you need. The insurance companies that offer Part D plans will charge a monthly premium and often have an annual deductible that can change each year. With Medicare Part D plans, the plan with the cheapest premium is not always the least expensive for you in the long run. Other variables can affect the price you pay as well. Whether your pharmacy is considered a “preferred” or “standard” pharmacy by the Plan will affect your cost, as will using the Plans “mail order” pharmacy if the plan offers one. And your prescription drugs themselves will affect your costs. All plans have their own “formulary” (list of covered drugs) and “tier” system. Check with prospective plans on where your specific drugs are categorized to determine what your copayment will be. You can enroll in a Part D plan or review and compare your current plan by contacting a certified SHIP Counselor at Roosevelt County Aging Services (406-653-6221), contacting Medicare at 800-MEDICARE, or going to www.medicare.gov.
