Anyone in Alabama with Medicare Part B is eligible for Medicare prescription drug coverage, and it’s a good idea to get it! Even if you don’t use enough prescription drugs to warrant buying insurance, your circumstances may change in the future. And should they change, not having prescription drug coverage could cause you a lot of financial trouble. Because you can only enroll in prescription drug plans at certain times, if you’re caught off guard by a sudden need for insurance, you may have to pay costs out of pocket for a period of time before you’re allowed to enroll in a plan. And generally, the longer you wait to buy drug coverage after becoming a Medicare beneficiary, the larger your penalty fees (link) will be once you enroll.
Medicare Part D vs. Medicare Advantage
You can choose to get Medicare through a Medicare Advantage Plan rather than through Medicare Part D. Both types of prescription drug coverage are administered by private insurance companies. Medicare Part D is a standalone prescription drug plan added on to Parts A and B, available in all Alabama counties. On the other hand, Medicare Advantage Plans are a package deal including everything Original Medicare does, with added services like dental coverage. They may include prescription drug coverage as well. Unlike Part D, Medicare Advantage Plans are restricted by your county and region.
If you’re currently in a Medicare Advantage Plan, you may find Medicare Part D offers you a better deal for prescription drug coverage. Keep in mind that once you enroll in Medicare Part D, you will be disenrolled from your Medicare Advantage plan immediately and returned to Original Medicare. The same thing happens if you try to enroll in a Medicare Advantage prescription drug plan from Original Medicare.
Enrolling in Medicare Part D may disqualify you from getting medical insurance from your union or employer as well (link?). Be sure to know your current plan’s compatibility with Medicare Part D before enrolling.
When to sign up
There are several times you can enroll in Medicare Part D. The first and largest window of time you have to sign up with is your Initial Enrollment Period (IEP). This period lasts for seven months around the time you become eligible for Medicare. For three months before the month you turn 65 (or three months before your 25th month of Social Security Disability benefits) and three months after, you can sign up for Medicare Part D without penalty.
If you didn’t sign up for Medicare Part D in this period, there is an Annual Election Period (AEP) every October 15th to December 7th. During this time you can decide to enroll in Medicare Part D, disenroll, or change your drug prescription plan.
Generally, the Annual Election Period is your only chance to enroll in Medicare Part D. However, there are conditions that will allow you to get a Special Election Period (SEP) and change/enroll in a prescription drug plan at other times of the year. For example, you can qualify if you change addresses and your new address doesn’t get prescription drug coverage from your previous plan.
What are my choices?
Shown below is a table including the Medicare Part D plans available in Alabama. There are five plans which offer extra drug coverage in the donut hole (link). The cheapest plan with a deductible has an $18.40 monthly premium, and the cheapest plan without a deductible has a $21.40 premium.
|Organization Name||Plan Name||Plan ID||Benefit Type||Total Premium||Drug Deductible||Gap Coverage
|Aetna Medicare||Aetna Medicare Rx Saver (PDP)||46||Actuarially Equivalent Standard||$25.00||$360.00||No|
|BlueRx (PDP)||BlueRx Option II (PDP)||1||Enhanced Alternative||$113.50||$0.00||No|
|BlueRx (PDP)||BlueRx Option I (PDP)||6||Actuarially Equivalent Standard||$70.30||$360.00||No|
|EnvisionRx Plus||EnvisionRxPlus Silver (PDP)||12||Actuarially Equivalent Standard||$34.60||$360.00||No|
|Express Scripts Medicare||Express Scripts Medicare – Value (PDP)||114||Actuarially Equivalent Standard||$30.70||$360.00||No|
|Express Scripts Medicare||Express Scripts Medicare – Choice (PDP)||182||Enhanced Alternative||$86.90||$360.00||No|
|First Health Part D||First Health Part D Value Plus (PDP)||135||Enhanced Alternative||$34.70||$0.00||Yes|
|First Health Part D||First Health Part D Premier Plus (PDP)||170||Enhanced Alternative||$71.30||$0.00||Yes|
|Humana Insurance Company||Humana Enhanced (PDP)||1||Enhanced Alternative||$66.20||$0.00||Yes|
|Humana Insurance Company||Humana Preferred Rx Plan (PDP)||106||Actuarially Equivalent Standard||$29.40||$360.00||No|
|Humana Insurance Company||Humana Walmart Rx Plan (PDP)||158||Enhanced Alternative||$18.40||$360.00||No|
|Magellan Rx Medicare||Magellan Rx Medicare Basic (PDP)||12||Actuarially Equivalent Standard||$32.80||$360.00||No|
|SilverScript||SilverScript Choice (PDP)||24||Basic Alternative||$21.40||$0.00||No|
|SilverScript||SilverScript Plus (PDP)||25||Enhanced Alternative||$77.30||$0.00||Yes|
|Stonebridge Life Insurance Company||Transamerica MedicareRx Classic (PDP)||11||Actuarially Equivalent Standard||$117.20||$360.00||No|
|Symphonix Health||Symphonix Value Rx (PDP)||16||Actuarially Equivalent Standard||$29.60||$360.00||No|
|Symphonix Health||Symphonix PrimeSaver Rx (PDP)||56||Enhanced Alternative||$38.60||$200.00||No|
|United American Insurance Company||United American – Enhanced (PDP)||15||Enhanced Alternative||$72.90||$90.00||Yes|
|United American Insurance Company||United American – Select (PDP)||83||Actuarially Equivalent Standard||$49.40||$360.00||No|
|United American Insurance Company||United American – Essential (PDP)||117||Enhanced Alternative||$42.20||$230.00||No|
|UnitedHealthcare||AARP MedicareRx Preferred (PDP)||11||Enhanced Alternative||$60.90||$0.00||No|
|UnitedHealthcare||AARP MedicareRx Saver Plus (PDP)||357||Actuarially Equivalent Standard||$39.30||$360.00||No|
|WellCare||WellCare Simple (PDP)||1||Actuarially Equivalent Standard||$27.10||$360.00||No|
|WellCare||WellCare Classic (PDP)||149||Basic Alternative||$27.80||$360.00||No|
|WellCare||WellCare Extra (PDP)||184||Enhanced Alternative||$67.10||$0.00||No|
Plans are subject to change as contracts are finalized.
Includes contracts/plans as of April 22, 2016. The data does not reflect information for Employer sponsored plans, Part B only plans, or plans not offering a Part D drug benefit.