Here Are Answers to The Most Common Part D Questions…

  • When is the Annual Enrollment Period for Part D?

    During the Annual Enrollment Period (AEP) Between October 15th and December 7th You Can…

    • Enroll in a new Part D plan, or…
    • Review and renew your current plan, or…
    • Change your current Part D plan

    Important: You don’t want to miss this once-a-year opportunity to review, renew, or enroll in Part D. If you are eligible and miss the Annual Enrollment Period (Oct 15 to Dec 7),then you risk being stuck in a wrong plan for you for 2015, or having to pay a LIFETIME penalty.

  • What if I like my plan and don’t want to change?

    If you are sure you will like your plan next year, then you will not need to do anything! You’re done. The new premium for 2015 will start on January 1, 2015 and will continue to be the same payment method you had in 2014.

  • What does Tier 1- 4 mean?

    Each plan has a Formulary (drug list) that shows what medicines are covered. In that Formulary they also give the drug a Tier level (between 1 and 5). The Tier level tells you what your copay or co-insurance will be. Tier level 1 is the lowest tier and is always a generic medication and it progresses up to the highest tier level in the plan which is Specialty medications.

    There is not a rule that tells companies what Tier level a drug must be so it can vary from plan to plan as it is up to the Insurance company when they design the Formulary.

  • Isn’t there anything cheaper?

    Be sure you are considering what pharmacy you have chosen. This will not change the premium but it may drastically reduce how much you are paying for copays or even give you a $0 copay if at a “Preferred Pharmacy”. It may make it worth going a little out of your way to use one of those pharmacies.

    Also make sure you consider using the Mail Order option if trying to maximize your savings. Most plans have mail order option, and in the majority there is some cost savings, but sometimes the cost savings is big!

  • What does it mean if there is a Quantity Limit?

    If this restriction is there then it means they will only pay for a certain amount each month. You can press on the word “Quantity Limit” and then it will show you what the Quantity limit is. If you take more than that then the insurance company would not pay for them, unless you file a request for an “Exception to the Quantity Limit”.

    Keep in mind, this doesn’t mean you can’t get more than their quantity listed. You may find if it is a generic, just buying the additional outside the plan is not any more expensive.

  • If my plan has given me an “Exception” this year, will it still be good next year?

    No, absolutely No! That is for your current year exclusively and sometimes isn’t granted for the full current year. Do not assume this Exception will continue next year. For your protection I would try to find a plan that works better with that particular medication so you do not have that worry.

  • What do I do about my insulin needles? I don’t see them anywhere in

    Good question. does not show the needles. If you have chosen a plan that works for your medications then I would call directly to the Non-Member phone number listed and ask them to see if your needles are covered in their plan.

  • What happens if a medication is not listed, will it be covered?

    None of us have a crystal ball to know what may be around the corneer for us in life. If you add a new medication during the year whether it is covered or not depends again on whether it is listed in your plan’s Formulary. Many people will take the Formulary you get with your Welcome Kit with them when they go to the doctor. This helps the doctor help you by choosing a medication that is covered in your plan for your diagnosis.

  • How do I know if my application processed?

    On the front page on the right hand side you will see a link, Check your current enrollment. If you press that and then fill in the personal information (Be sure to enter your Medicare ID number without dashes), it will show you what plan you have for Part D beginning January 1, 2015. If you do not see anything there then it did not go through, but again make sure you give it time to process before jumping to conclusions. Nothing in our government moves fast!

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Due to the high volume of requests, we appreciate your patience while we give each customer our full attention. We have provided answers to the most frequently asked questions in the resources on this site for your convenience.

Feedback Our Medigap360 Family…

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“Thank you Becky! The tool was easy and after going through it…the plan I currently have was on top! Easy for me, this year I’m going to keep the plan I had last year! Thanks for your notices and helping me to keep straight!”