Congress passed federal legislation creating the Medicare Part D, Prescription Drug Assistance Program in 2003 and the program was implemented January 1, 2006. This program is available to anyone eligible for Medicare Part A or Part B. People with Medicare may enroll in Part D coverage through either a stand-alone plan or a Medicare Advantage plan. People on Medicare who choose not to enroll and have no other drug coverage may pay a penalty for late enrollment.
Each year, during open enrollment (October 15th - December 7th) you should review your Part D plan options and look for three things:
- Convenience – know what pharmacies you can use;
- Cost – know all the possible out-of-pocket expenses you may have to pay;
- Coverage – make sure the list of covered drugs (formulary) includes your prescriptions.
People who are new to Medicare have a seven-month enrollment to choose a Part D plan – three months before their birthday, the month of their birthday, and three months after their birthday.
People who miss their initial enrollment period can enroll during open enrollment (October 15 – December 7) to enroll or change plans for the following calendar year.
People who lose their creditable coverage have 63 days from the plan termination to enroll in a Part D plan with no penalty.
Depending upon your income, individuals may be eligible for the LIS (Low-Income Subsidy) Assistance “Extra Help” program, which helps pay your premiums, helps pay your drug costs, and keeps you out of the “donut hole”.
For assistance in reviewing your Part D plan, or eligibility for the Extra Help program, AAA7 has a Benefits Specialist to help you. Call 800-582-7277 and ask for Kristy Bowman, extension 250, or e-mail info@aaa7.org.
