Medicare Part D

The Medicare Part D program has helped millions of Medicare recipients pay for their prescription drugs since January, 2006. Over 1,400 insurance plans are on the market that offers an assortment of prescription benefits that are strikingly similar. We have invested a tremendous amount of hours to figure out which Part D plan is best for each individual’s situation.

There are open enrollment periods, donut holes, annual election periods, late enrollment penalties, tiers, formularies, and dozens of more terms that are specific to the Medicare Part D industry. Accurate information leads to a wise decision. Medicare recipients should specifically concentrate on the dates of the various open enrollment periods. We thank you for continuing to show confidence in our knowledge of all aspects of the Medicare insurance industry.

Medicare Advantage Plan

The benefit you deserve.

More than 10 million Americans have already joined a Medicare Advantage plan!

CIGNA Medicare Access (PFFS) is part of the federal Medicare program and offers you all the protection and funding of the Original Medicare (Parts A and B) with predictable costs and so much more – even dental, vision, and hearing benefits.

More than Medicare.

With a CIGNA Medicare Access (PFFS) Plan you will enjoy:

  • Low predictable costs
  • Freedom to choose any doctor who accepts our plan
  • 100% coverage if your yearly costs are too high
  • Nationwide coverage and worldwide emergency coverage
  • Routine vision and hearing exams (plans 3 and 4 also include a vision hardware allowance)
  • A dental benefit that pays for 75% of preventive procedures, and you can use your own dentist!
  • Prescription drug coverage with most common drugs used by seniors included on the drug list (Plans 2 and 4)

The benefit information provided here is a brief summary, but not a comprehensive description of your available benefits. Additional information about benefits is available to assist you in making a decision about your coverage.

Guide to Medicare Part D – Important Points

  1. The cost, coverages, convenience and Part D company ratings
  2. Different types of generics, and your out of pocket cost.
  3. Mail ordering. Is it the best way to buy prescriptions?
  4. Is there still a late enrollment penalty? Is it being enforced?
  5. What is the preferred method to pay?
  6. Cutoff dates and other important information.

 

The Costs, Coverages, Convenience, & Company Ratings:

The Centers for Medicare and Medicaid Services (CMS) recommends when choosing a Part D plan that Medicare recipients should focus on the following factors: Costs, Coverages & Convenience of the company. Best Medicare supplement highly recommends that the Medicare recipient should consider the strength of the insurer as a primary factor. Many Medicare recipients have no clue as to the relative strength and stability of the various Medicare Part D companies. There is help on the way.  In 2008, a Part D plan rating system was implemented to publicize Medicare recipients’ experiences with the various Part D Plans.

 

Different types of generics, and your out of pocket cost

Question: The Medicare Part D Guide Cap Coverage is confusing to understand because the difference between preferred generics and regular generics is not clear. There are Part D plans that will cover “all preferred generics” or “some generics” or “all generics.” I cannot understand this, what does this mean?

Answer: These various “generic drug” terms do not have an industry wide meaning. Each Part D insurer defines the term as it sees fit. An insurer’s “preferred generic” can be completely different than another Part D plan’s list completely. What is the reason for all this confusion and why is there not an industry standard? In our humble opinion, this was a mistake in the Part D legislation that should be rectified in the near future. There are Part D insurances that are limiting their donut hole coverage and the different “categories” of generic drugs is a way for the Part D insurer to not cover all generic drugs in the donut hole.

Most Medicare Part D plans will cover the widely used and popular generic drugs as common generics. An important point is that even if generic drugs are covered through the donut hole, your co-payments may increase during the donut hole. The specific Part D will give specific details as to this point.

 

Mail ordering. Is it the best way to buy prescriptions?

Question: Is the Medicare Part D plan mail order option good for you?

Answer: Using Part D plan’s mail order plan will save you money in almost all circumstances. Having a personal relationship with your local pharmacist does have value and lower cost of drugs will make the donut hole come faster.

 

Is there still a late enrollment penalty? Is it being enforced?

Question: Not taking any prescription drugs caused me to bypass the initial Part D plan open enrollment period. Things have changed and I would like to join Part D. Will there be a late penalty and how much will it be?

Answer: There is a late penalty and Medicare recipients will receive a letter from their Part D insurance concerning the penalty amount. The Part D late enrollment premium penalty is calculated by the Center for Medicare and Medicaid Services and then reported to the Part D insurer. You will be sent a letter by the Part D insurer as to the exact amount of the penalty.

The Part D insurer letter will detail the calculations that went into the amount of the penalty and inform you that the late enrollment penalty can be protested via proper government channels. Those who are qualified low income recipients are not subject to the Part D late enrollment penalty until the end of 2007.

 

What is the preferred method to pay?

Question: Is there a best way to pay for Medicare Part D?

Answer: Bank draft, Social Security deductions, credit cards, and personal checks are the options. Part D premiums can be paid in a variety of ways. Our personal recommendations for Medicare beneficiaries to pay the Medicare Part D payments via bank draft with the bank account that has the highest balance. This will ensure that your Part D coverage will no lapse by accident.

 

Cutoff dates and other important information.

November 15th is when the “annual enrollment period” (AEP) starts. A Medicare beneficiary can obtain new Part D drug coverage or a new Medicare advantage insurer. The coverage will start on January 1.

A Medicare beneficiary that doesn’t nothing regarding Medicare advantage plan or Part D will stay in his or her current plan throughout the following year. One should analyze the changes in your current Part D plan’s benefits in order to make a good decision.

December 31 is when the annual open enrollment period ends and the following year is the earliest that one can join Part D plan or switch plans, with some exceptions. Those who did not take any Part D plan will probably pay a lifetime penalty when they finally join a plan.

The Medicare Advantage insurance has an additional open enrollment period from January 1 to March 31. During this period one cannot add Medicare prescription drug coverage but those with a prescription Part D drug plan can join a Medicare Advantage plan with a prescription drug benefit.

Those who are low income are dual eligible and can change Medicare Part D plans all year round on the first of the month. One must realize that changing Medicare Part D drug plans once a month is a bit silly. Finding a Part D insurance that is subsidized by the state low income subsidy and covers all of your drug medications would be a wise decision.

Those new to Medicare have a seven month window to join a Part D insurance. (three months before you can receive Medicare & 4 months after your Medicare eligibility begins) Medicare recipients in the initial enrollment period can enroll in a Part D plan for just December and can stay in your choose drug supplement plan the following year, or select a completely different Part D insurance.