There are many Utah Medicare Part D plans to choose from to help with your prescription costs.  Medicare prescription coverage also known as “Part D” or “PDP” adds to your Medicare coverage.  It helps pay for both brand name and generic drugs.  These plans are offered through private insurance companies that are approved by Medicare.  You can get your Part D coverage two ways.

  • Purchase it as a Stand Alone PDP plan
  • Enroll in a Medicare Advantage Plan that includes Part D also

In Utah there many Medicare Advantage plans that has the Part D coverage included with it.  If you have a Medicare Supplement though, you will need to purchase a stand alone PDP plan if you want prescription coverage.

There are 4 good things to consider when choosing a Medicare Part D plan

  • Coverage:   All plans must cover the same categories of drugs, but plans can choose which specific drugs are covered in each category.  We can help you make sure your medications are covered on the plans formulary (list of covered drugs).

 

  • Cost:  You drug coverage costs are affected by monthly premium, yearly deductible, co-pays or coinsurance and the coverage gap.  How much you pay for each prescription depends on which plan you choose.  If you have limited income and resources, you may qualify for Extra Help from Medicare to help you pay for you drug plan costs.

 

  • Convenience:  Some plans allow you to get your prescriptions by mail.  This is a good option for maintenance type medications that you have to take every month.  It can sometimes save you a little more money off your co-pays also.

 

  • Quality:  All plans have been rated by Medicare in different categories, like customer service.  It is important to take the plans rating into consideration before enrolling.

 

There are also 4 stages to every Medicare Part D plan. In each stage, the amount you pay for your prescription drugs is different.

 

Help paying for Prescription Drug costs

Eligible individuals who have limited income may qualify for a government program from Medicare.  The Medicare Low Income Subsidy (LIS) program also known as the Medicare Extra Help program, helps pay for the costs of prescription drugs, the monthly Medicare Part B premium, annual deductible, co-pays and coinsurance. Also, individuals enrolled in the Extra Help program do not have a gap in their prescription drug coverage, also known as the Medicare Donut hole.

To qualify for Low Income Subsidy in Utah for 2012 your annual income needs to be less than $16,245 (single) or $21,855 (married).  Your assets also need to be less than $12,510 (single) or $25,010 (married).

If you are unsure if you qualify or your income is slightly higher, you should still go ahead and apply to see if you are eligible.  The worst they can say is no right?  But if you can qualify, it will help pay for a lot of the costs.

To see if you qualify for Low Income Subsidy contact the Social Security Administration at 1-800-772-1213 or apply online at https://secure.ssa.gov/i1020/start

When can you sign up for a Medicare Part D  Plan?

You can enroll in a Medicare Advantage Plan (Part C) when you first become eligible for Medicare.  It is a 7 month window that starts 3 months before your 65th birthday, the month of, and 3 months after your birthday month.

Medicare Initial Enrollment Period
(7-Month time period)


 

If you are under 65 and receive Social Security disability, you qualify in the 25th month after you begin receiving your Social Security benefits.

 

Medicare Disability Eligibility

If you are already enrolled in Original Medicare, they you must wait until the next enrollment period to sign up for a Medicare Advantage Plan.  The Annual Enrollment Period (AEP) is from October 15th through December 7th each year and coverage begins on January 1st of the following year.

Generally, once you enroll, you stay enrolled until the next Annual Enrollment Period becomes available.  However, there are some situations that might qualify you to make a change during the rest of the year.  An example of these situations include:

  • You move outside your Medicare Advantage Plans service area
  • You qualify for Extra Help (A program to help you afford prescriptions drugs)
  • Loosing Employer coverage from your company
  • If you move into an institution (such as a nursing home)

What is the Late Enrollment Penalty?

The late enrollment penalty is an amount that is added to your Part D premium if you had Medicare but didn’t have creditable drug coverage during that time. You may owe a late enrollment penalty if one of the following is true:

  • You didn’t join a Medicare drug plan when you were first eligible for Medicare, and you didn’t have other creditable prescription drug coverage. Creditable Prescription Drug Coverage is coverage that is expected to pay, on average, at least as much as Medicare’s standard prescription drug coverage. Usually, this coverage is provided from an employer or union. People who have this kind of coverage when they become eligible for Medicare can generally keep that coverage without paying a penalty if they decide to enroll in a Medicare Prescription Drug plan later.
  • You didn’t have Medicare prescription drug coverage or other creditable prescription drug coverage for 63 days or more in a row.

 

 

Utah Medicare Part D plans are all a little bit different and we’ll do the work for you to compare your medications to see what Part D plan will be the most cost effective, saving you time and money!  We are a local Utah company and have helped thousands of Medicare beneficiaries here in Utah choose the right plan for their needs.  We even can come to you and do in-home appointments in the comfort of your own home to help compare your prescription drug costs.  Learn, Compare and Save time and money with us!  Call us today… we can help.  1-866-502-7736 or 801-372-4206