2 easy steps to choosing the Medicare Part D plan that is right for you
Even if you are currently in a Medicare Part D plan you should reevaluate it every year. Here’s how:
- Go to Rite Aid’s Medicare Advisor and follow the simple instructions to get a list of the plans you should consider.
- Once you choose a plan you can enroll through the Medicare Advisor or you can talk to a Representative at 888-391-2661
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Elixir Insurance is a Prescription Drug Plan with a Medicare contract. Enrollment in Elixir Insurance depends on contract renewal.
Other pharmacies are available in the Elixir Insurance network. Customers can choose from many Med D plans in which Rite Aid participates.
What is Medicare Part D?
If you are enrolled in Medicare, you may be able to save a significant amount of money on your prescriptions with Medicare Part D. Signing up for Medicare Part D allows you to choose a private prescription plan—much like you would with other insurance policies—in order to find one that saves you the most money on your medications.
10 Facts about Medicare Part D
1. Open to Anyone with Medicare
Medicare Part D plans are open to everyone eligible for Medicare in the US. and US. territories. Generally, that means anyone 65 years old or older and some younger people with certain disabilities. You cannot be denied coverage for health reasons. Participation is voluntary, which means you get to decide if you want to enroll or not. If you have Medicare and Medicaid, you will be enrolled automatically, so there is no lapse in your Medicaid prescription drug coverage. The annual open enrollment period is October 15 to December 7, for coverage beginning January 1. If you decide to join later, your monthly premiums may be higher because there's an additional fee for late enrollment.
2. You Pay to Participate
Participation in Medicare Part D has a cost and you will pay a portion. However, much of the cost is paid for by the government. Typically, the government pays about 75 percent of the enrollment costs of your chosen plan and you pay the rest.
3. Participation Means Peace of Mind
All of the Part D plans are private insurance plans. Most participants will pay a monthly premium, but that premium buys you the peace of mind of knowing that if your drug costs become very high, you will be protected.
4. Plan Members Can Access Discounted Prices
If you join a Part D plan and use the plan's network pharmacies, you'll have access to discounted prices. Plans often negotiate lower prices with drug companies and pass those savings along to you.
5. You Choose Your Plan
When you enroll in Medicare Part D, you can choose which plan best meets your needs. Companies release details of their plans after October 1 each year, and you’ll be able to change your plan once a year. Although every plan must meet the government’s basic requirements, there will be differences among different plans, including what drugs are covered and what pharmacies you can use.
6. There Are Two Types of Plans
Plans come in two basic types. The most simple is a prescription drug plan (sometimes called a PDP), which covers only drugs and can be used with your traditional Medicare and/or a Medicare supplement plan. The other type combines a prescription drug plan with a Medicare Advantage plan and includes medical coverage for doctor visits and hospital expenses. This kind of plan is called Medicare Advantage plus Prescription Drug, or MA-PD.
7. Enroll Late, Pay More
If you do not enroll when you first become eligible, you may pay more when you sign up later. The late enrollment fee is approximately one percent of your premium for each month you delay, and you'll pay it for as long as you stay in a Part D plan. If you enroll late because you were participating in a qualified prescription drug plan, such as a plan from your former employer, the fees may not apply to you. Additionally, if you are eligible for the low-income subsidy, the fee may not apply.
8. Each Plan has a Drug Formulary
Each Part D drug plan will have its own government-approved list of the drugs it covers, called a formulary or preferred-drug list. The formulary may vary from plan to plan, but you and your doctor will have choices. Before you choose a plan, you'll probably want to compare plan formularies to see which one best fits your needs.
9. Drugs are not free of charge, but the cost will be significantly reduced
Although your drugs won’t be free of charge, the cost will be significantly reduced. For each prescription, you'll pay a portion of the cost. Your plan will help you with some of the costs, but how much you pay and how much your plan pays will vary.
10. There Is Extra Help Available for People Who Need It
If you have a lower income, you may be able to get extra help. Your premiums may be reduced or eliminated, and other payments may also be less.
Medicare Part D FAQs
If you are already enrolled in the Medicare prescription drug program, you may be able to receive extra help from the Social Security Administration (SSA). Eligible enrollees can get help paying for monthly premiums, annual deductibles, and copayments related to Medicare Part D. To find out if you qualify for extra help and to apply, please visit the SSA website.
All individuals with Medicare Part A or Medicare Part B are eligible to enroll regardless of age, income, or health conditions.
No, you do not have to participate. It is your choice. However, similar to other types of insurance, the longer you wait, the higher your premium will be.
You will need to review your options carefully to see if a Part D plan is right for you. Part D plans are designed to provide financial savings to most people with Medicare. As insurance plans, they provide protection against future, unexpected costs. They also provide additional financial assistance for people with lower incomes.
Congress believes that unless you already have creditable prescription drug coverage, Part D plans are a great way for you to get help with the cost of prescription drugs. They crafted the rules to encourage people to enroll in the beginning instead of waiting to join only when health problems develop and drug costs rise. The late enrollment fee gives people a reason not to postpone the decision to join.
In October, you will begin to receive specific information about the options available to you. First, you will receive the “Medicare & You” handbook, which will include all of the plans available in your area. Second, in October, the plans will begin releasing specific plan information, including plan costs, the list of covered drugs (formulary), and the list of network pharmacies. Information will also be available at www.medicare.gov, the Medicare website.
If you have both Medicare and Medicaid, you already qualify for low-income assistance. If you don't qualify for Medicaid, you may still qualify for some assistance. Visit https://secure.ssa.gov/i1020/start .
If you have both Medicare and Medicaid, you already qualify for low-income assistance. If you don't qualify for Medicaid, you may still qualify for some assistance. Visit https://secure.ssa.gov/i1020/start .
Yes, you can change your Part D plan. The opportunities to switch are: Annual enrollment: Each year, you will be able to choose a different Part D prescription drug plan or Medicare Advantage plan during an annual enrollment period that lasts from October 15 through December 7. Coverage under the new plan will begin the following January 1. Other exceptions: There are other limited exceptions that may give you the right to switch plans during a year. For example, if you move out of the service area of your current plan, you will have an opportunity to choose another plan that serves your new area
Each Part D plan will provide its own formulary, or list of covered drugs. This information will be available through the plan's website, customer service center, and marketing materials.
All Part D plans must meet formulary requirements set by Medicare. The formulary will include both generic and brand name drugs. Each plan must use a Pharmacy and Therapeutics Committee, which includes doctors and pharmacists, to establish its formulary. This process assures you that you'll have access to a number of drugs, although not necessarily all drugs.
The drugs that are excluded from Part D by Medicare are: Drugs used for anorexia, weight loss, or weight gain Drugs used to promote fertility Drugs used for cosmetic purposes or hair growth Drugs used for the symptomatic relief of cough and colds Prescription vitamins and mineral products, except prenatal vitamins and fluoride preparations Non-prescription drugs Inpatient drugs Barbiturates (sleeping pills) - except when used to treat epilepsy, cancer, or a chronic mental health disorder In addition, a drug cannot be covered under a Part D plan if payment for that drug is available under Part A or B of Medicare, such as drugs administered in a hospital or a physician's office. Also, each Part D prescription drug plan may have its own specific exclusions.
Yes. Medicare Part D plans are available in the US. territories.
No. Only drugs sold in the United States are eligible for Part D coverage.
The introduction of Part D prescription drug plans in January 2006 had no impact on Veterans' Administration benefits. Medicare beneficiaries who currently have prescription drug benefits through the VA will be able to continue to obtain their prescriptions through the VA.
Medicare Part D Glossary
October 15 through December 7, which is generally the only time of each year that you can change plans (unless you meet certain special exceptions, such as moving out of your plan's service area or you are covered by Medicaid).
The percent that you pay for a covered drug. With some plans, you do not pay coinsurance until you have first paid a deductible.
This is the set amount you pay for each covered drug. Different co-pays may apply depending on the type of drug (brand or generic) or the days’ supply of the prescription (30 or 90 days). See "Drug Tiers".
Amount you pay for Medicare prescription drug coverage after the initial coverage limit and until the total amount paid by you and your plan for covered prescription drugs reaches the limit. This amount changes each year. The coverage gap is sometimes referred to as a "donut hole."
Drug coverage that is at least as good as Medicare prescription drug coverage.
A set amount of dollars you must pay before you receive coverage for your benefits.
See "Coverage Gap."
Drug tiers allow plans to group different types of drugs together on their preferred drug lists (such as generic drugs, brand name drugs, or preferred brand name drugs). For example, a two-tier pharmacy plan will have two different co-pay options. The lower co-pay may apply to generic drugs, and the higher co-pay may apply to brand name drugs.
A list of drugs covered by a health insurance plan. This list must always meet Medicare's requirements and is sometimes called a "preferred drug list."
The payment you make to a health insurance company for your health plan.
The increased amount you may have to pay if you do not apply for Part D (Medicare prescription drug coverage) when you are first eligible. If you don't join when you are first eligible, and you don't currently have a drug plan that is at least as good as Medicare prescription drug coverage, you may have to pay a penalty that increases the cost of the monthly premium by one percent for every month you wait to join.
A drug that typically requires the lowest co-pay.
See "Formulary."
Amount you pay for your covered prescriptions. This amount changes each year and may be paid by another person, or by a qualified state pharmaceutical assistance program (SPAP), on your behalf.
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