About Medicare Part D
Medicare Basics
Understanding how Medicare works can help you make an informed decision about which SilverScript prescription drug plan is right for you.
What is Medicare?
Medicare is health insurance administered by the federal government for people
- age 65 or older
- under age 65 with certain, qualifying disabilities
- with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant).
- Medicare Part
-
- What it Covers
-
- Description of Coverage
- Part A
Hospital Coverage-
- Hospital inpatient care
- Skilled nursing facility care
- Hospice care
- Home health care
- Part B
Medical Coverage-
- Doctor and clinical lab services
- Outpatient and (some) preventive care
- Screenings, surgical fees and supplies
- Physical and occupational therapy
- Part C
called Medicare Advantage
Combines Part A and Part B, and may include Part D- A different way of getting Medicare Part A and Part B coverage. Medicare Advantage plans (MA plans) combine Part A and Part B together in one plan. MA plans can also be combined with a Part D prescription drug benefit for complete Medicare coverage, called Medicare Advantage Prescription Drug (MA-PD) plans. Generally, these Medicare Advantage plans are offered as:
- Preferred Provider Organizations (PPO plans)
- Health Maintenance Organizations (HMO plans)
- Private Fee-for-Service (PFFS plans)
- Part D
Prescription Drug Coverage- Available as stand-alone coverage (such as SilverScript plans, called PDPs), and also as a prescription drug benefit added to a Medicare Advantage Prescription Drug Plan (MA-PD).
Medicare Part D
Whether you're new to Medicare, or already enrolled in a Medicare plan, we're here to help you make sense of Medicare Prescription Drug Plans.
Click on the questions below to find out more about Medicare Prescription Drug plans.
What is Medicare Prescription Drug Coverage (Medicare Part D)?
Medicare Part D is a federal program that helps people with Medicare pay the costs of prescription drugs. It was enacted as part of the Medicare Modernization Act of 2003 and went into effect January 1, 2006. Medicare Part D is administered by private insurers approved by Medicare. SilverScript prescription drug plans are Medicare approved, and offer formularies (list of covered drugs) are designed specifically for people with Medicare.
Am I eligible for Medicare Prescription Drug Coverage?
- You are eligible to enroll in a Medicare Prescription Drug Plan if you are entitled to Medicare benefits under Medicare Part A and/or enrolled in Medicare Part B.
- At any given time, you may only be enrolled in one plan that provides Medicare prescription drug coverage.
When can I enroll in a Medicare Prescription Drug Plan?
- If you are eligible for Medicare because you are turning 65, you may enroll three months before the month you turn 65, during the month of your 65th birthday, and three months after the month you turn 65. This time period is your Initial Enrollment Period (IEP).
- If you are eligible for Medicare due to disability, you may enroll in Medicare prescription drug coverage three months before your 25th month of Social Security Disability Payments and up to three months afterward.
- If you choose not to enroll in a Medicare prescription drug plan when you become eligible—and do not have creditable drug coverage (coverage as good as Medicare coverage)—you may have to pay a late enrollment penalty.
How can I receive Extra Help from Medicare?
You may be able to get Extra Help to pay for your prescription drug premiums and costs. To see if you qualify for Extra Help, call:
- 1-800-MEDICARE (1-800-633-4227); TTY users should call 1-877-486-2048, 24 hours a day, 7 days a week, or
- Social Security Administration at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday (TTY users should call 1-800-325-0778), or
- Your State Medicaid Office.