How and When to Enroll in Medicare Part D

[@Squddle]

What happens if you are healthy, have a part D plan, and the part d plan removes some medications from it's formulary. You aren't worried, because you are healthy, BUT, then, a month or two later, you get sick and need the medication that your plan just removed. You had no need for that medication when it was removed, but, now need it. And the enrollment period has passed to find a plan that does have it on their formulary.

[@vistamutual]

Well explained!

[@BoomerBenefits]

Thanks!

[@curtw8827]

I have the lowest premium SilverScript plan, it has to be booked direct with Aetna because it is not sold through an independent agent, higher monthly premium plans are available through an independent agent.

[@BoomerBenefits]

You should be getting your Annual Notice of Change in the mail this month to advise you of any Part D changes!

[@mainerin_texas-gordon-9598]

Bonus - You assist with Part D also, thank you

[@BoomerBenefits]

YES! We have a department that specializes in drug plans.

[@nonenone4219]

Are all Medicare part D plans the same choices regardless of the insurance company you choose? Kind of like how medigap plans work?

[@BoomerBenefits]

Great question - Part D plans are more tailored to what medications you take and pharmacy you use. You will want to go over those on a Plan Finder tool and see what works best for you!

[@nonenone4219]

@BoomerBenefits Appreciate your reply. I absolutely love all the videos you post. They are extremely informative and helpful to all of us who are just embarking on this new and confusing journey called Medicare. Thank you much.

[@karadouglas4449]

how do we know if an Advantage plan includes part d coverage??

[@BoomerBenefits]

Hi Kara - very important concern! Your agent should let you know if you are enrolled into a Medicare Advantage or a Medicare Advantage Prescription Drug Plan. You can look on your ID card as well and it should let you know about your prescription benefits. If you do not have that, please give us a call at 817-249-8600 so that we can help!

[@karadouglas4449]

@@BoomerBenefits thank you!!

[@latriciapowell3283]

Thanks for the info… but how can I make sure the Part D plan I choose will cover my medications? Or if I get a new prescription after I already sign up??

[@BoomerBenefits]

Hi Latricia - great question! Here at Boomer Benefits, we specialize in making sure you are on the correct plan based on your medications. If you ever get a new medication, you can contact our Client Service Team and they can help you see what your new medication cost will be and if for some reason it isn't covered, will help you with alternatives or filing an authorization with the plan & your provider!

[@Scott-ff2oe]

Thank you.

[@BoomerBenefits]

You're welcome!

[@osiumeh6261]

Great information on your video. Got a question. I have always heard that if you have FEHB, you do not need to have Part D. Have that changed?

[@BoomerBenefits]

Thanks for watching! If your FEHB coverage is creditable, you typically do not need a drug plan!

[@osiumeh6261]

@@BoomerBenefits Thank you.

[@nellie...]

I enrolled on September 2023, I have a advantage plan that covers medications can I cancel?

[@BoomerBenefits]

If you enrolled in a Medicare Advantage plan with drug coverage, your drug plan should be automatically cancelled.

[@nellie...]

@@BoomerBenefits Thanks

[@Miasophia22]

if I am turning 65 in May, I am now applying for parts A & B. I have private health insurance not group coverage. when do I sign up for a supplement plan and a part d plan?

[@BoomerBenefits]

Hi Joanne, you will want to start the process this month if possible! We recommend 3 months before you birthday. You can call us at 817-249-8600 for help!

[@kennnva551]

Should I sign up for Part D if I don't plan to retire until I'm 66? I currently have prescription drug coverage through my employer until I retire. I did sign up for Medicare Part A as required for 65 year-olds. Never mind ... just saw your video saying my enrollment period for Part D is the 2 months immediately following my retirement date.

[@BoomerBenefits]

Hi Ken, glad you saw the other video! Let us know if you need other help :)

[@alexroland8058]

Thanks for the video! One question though, if I am retired and have retiree coverage, but want to drop that insurance and go with a Medigap plan and Part D plan, will I have a penalty because I didn't sign up initially or is retiree coverage considered creditable?

[@BoomerBenefits]

Hi Alex - Typically retiree coverage is considered creditable. The best thing to do is to ask your employer to verify it is creditable. if so, you should not run into any issues!

[@hanqiao1]

My case, 68, already in Part A, not in Part B as still working with a big employer. Question: Special Enrolment Period for Part B has an 8 month window period after stop working to enroll, but Part D has a 2 month window, if I get enrolled Part B last month in window period, then enrolled in Part D, any penalty for D on me? Another question, Can I join an Advantage Plan with drug coverage after Part A/B, no need to have Part D?

[@BoomerBenefits]

Hi there - if you were to wait until the end of that 8 month window to enroll into a drug plan or a Medicare Advantage plan, you would face a penalty of about 6 months. For the drug plan, you only have 60 days after leaving employer coverage to enroll. If you have Part A & Part B as well as a Medicare Advantage plan, you will not need a Part D plan.

[@hanqiao1]

@@BoomerBenefits Not clear if Part D enrolment requires both Part A/B or just A. But Advantage requires both. Thank you for your reply. Those policies tricky indeed.

[@stevenichols4639]

How do you find out tier pricing for each part d plan?

[@BoomerBenefits]

Hi Steve - you will want to check the formulary for your plan. You will be able to access this through your portal with the carrier or by calling your agent!

[@mikeberg5003]

Thanks Danielle for the info. I think the problem that my wife and I have is that we signed up for a Part D plan to go along with our Blue Shield supplemental without realizing we each have a $500 deductible. Ouch. I only take one drug a daily asthma inhaler that until my deductible kicks in, costs $350. After that it's $45/month. I went online to see if we could change during an open enrollment but if I find a plan that has a lower deductible, the premiums are absurd, $75-$90/month with a smaller deductible but most are like ours with the $500 deductible and about a $10/premiium. Am I missing anything? We live in southern California.

[@BoomerBenefits]

Hi Mike - inhalers can be pretty pricey on Medicare. The standard deductible for 2023 is $500, so the more expensive your premium, your deductible can be lower. Have you looked on cleverrx.com/boomer for a coupon on your inhaler?

[@mikeberg5003]

@@BoomerBenefits Thanks Danielle. No I haven't checked but I will for sure. Thank you!

[@BoomerBenefits]

@@mikeberg5003 You can watch a video to learn more here - kzbin.info/www/bejne/q4vWia14j5WSe5o

[@danbro1970]

I purchased my Medigap Plan G policy through you a few years ago and have a separate Part D policy through BCBS. Can you please explain the new Medicare drug law? I heard you do not have to pay more than $2000 out of pocket beginning in 2025, but I also heard this does not apply to any of the newer drugs - only older drugs. Additionally, I was recently prescribed a drug, Mounjaro, by my endocrinologist for my Type II diabetes. It was denied by my Part D policy (BCBS) for not being in their formulary, but I could get a similar drug (not the same), Ozempic. I later saw a TV news report that many drugs that are excluded from formularies by insurance companies are done so because the manufacturer does not pay "kickbacks", i.e., discounts that are not passed on to the policyholders. Does this happen? Could this be why Mounjaro was excluded from the formulary and denied to me?? Thanks!

[@BoomerBenefits]

Hi there - Yes, that cap does start in 2025. As far as we know, it should be all drugs included. Each drug plan has a formulary, which tells you every drug covered by the plan. Since Mounjaro isn't covered, you would have to file for a formulary exception to see about getting coverage. Some new medications, such as Mounjaro are not covered by many plans - that could be the main reason.

[@rayberger2694]

I have a question, I am reading my medicare handbook that came with my medicare card, and on page 20 of the booklet it says that my 6 month window to buy a medigap policy starts when my part B coverage starts ? So I am confused now, Because you said something about 3 months before and 3 months after, or are we talking about two different things.

[@BoomerBenefits]

Hi there - that is for your Part D plan, Medigap is the month of your birthday and the 6 months after.

[@NoelLudvigson]

Really like that BB will also help with D hiccups!

[@BoomerBenefits]

We love to be able to help our clients!