Medicare Part D – Tips to Know
By Kyle Davis, TARCOG

If you HAVE enrolled in a Medicare prescription drug plan (Part D)…
            …and you enrolled before Dec 31

• Your benefits began Jan 1.

…and you enrolled on Jan 1 or later

• Your benefits begin the 1st day of the month following your enrollment (i.e. Jan 6 enrollment, coverage begins Feb 1)

When you go to the pharmacy

• Take your prescription drug plan card (if you have one) OR your Medicare card, photo ID, and enrollment letter (also take your Medicaid card if applicable)
• Know your benefits/coverage
• Keep your receipts

Good things to know

• Your plan must give 60 days notice before removing a drug from their coverage list (formulary). 
• Each plan must have a transition policy in place in case a drug you need is not covered by the plan.
• You have a right to ask for a reconsideration (file an appeal) if a drug you need is not covered by your plan. This may be done with the help of your doctor. 

If you have NOT YET enrolled …
            …you still have until May 15 to choose a plan and enroll without paying a penalty.

• You should take a close look at this if you do not have drug coverage.
• If you do have drug coverage, talk with your current provider to determine what you should do.
• Engage your healthcare providers and family in the decision-making process.

…be mindful of marketing practices and sales representatives.

• Pay special attention to any signs that may be near the work station. (For example: Medicare Information …by XXX Insurance)
• Do not make a decision based on fancy advertisements or nice plan representatives. The decision you make should be based on your needs.
• If a person is representing one or several companies (or prescription drug plans), s/he will try to persuade you to enroll with his/her plan(s) and may even facilitate the enrollment process.

Good things to know….

• Medicare’s hotline and website are available 24/7 to assist you with making an educated decision about your prescription drug coverage.
• Your pharmacist and his/her staff can assist with making an educated decision.
• If your situation is complex, Medicare counselors are available through the SHIP program and the Area Agencies on Aging to help you make an educated decision. 

Who do I call???
Medicare – 24 hours a day/7 days a week 1-800-MEDICARE (633-4227) or www.medicare.gov

• Medicare has created a plan finder tool to help people make decisions based on their preferences and more importantly, their needs. The tool is available on Medicare’s website as well as via 800-Medicare operators. 

State Health Insurance Assistance Program (SHIP) – Weekdays, normal business hours
1-800-AGELINE or  www.shiptalk.org (Click on “Find a Counselor”)

• SHIP counselors are the “local face” of Medicare and can provide free, unbiased, one-on-one counseling and assistance. Each state has a SHIP program. 

 
Social Security Administration – 7am to 7pm (all time zones)
*financial assistance for beneficiaries w/ lower-incomes and limited resources
1-800-772-1213 or www.ssa.gov

• SSA staff can help complete applications for “extra help”.
• Applications may be completed in person, by phone, & online via the SSA website

Prescription Drug Plan Provider or Employer/Union Benefits Administrator
*Contact your plan with any questions about coverage or benefits. 

• You can find the number on your enrollment letter or the back of your insurance card.
• To avoid interruption or loss of benefits, always check with your plan/employer before adding additional coverage. 

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Alabama Department of Senior Services