The state of North Carolina features 23 Medicare Part D plans designed to meet your prescription drug needs. The plans are offered from 13 different third-party health care organizations under the supervision of the federal government. To take advantage of one of these plans, you’ll first need to be enrolled in Original Medicare Part A and Part B. Once you’ve accomplished that, you’re free to apply to the Part D plan of your choice, either via the website of the company offering the plan, or in person if said company requires an old-school paper application.
In either case, you’ll want to apply as soon as you’re eligible. If you do not, you risk incurring late fees, health audits that may affect your ability to secure insurance coverage, and higher monthly premium costs if you do secure it.
Medicare Part D vs. Medicare Advantage
In addition to considering Medicare Part D, you might be looking into Medicare Advantage (sometimes called Medicare Part C) as a way to address your prescription drug costs. Medicare Advantage is similar to Part D in that both programs are administered by third party programs under the direction of Medicare itself. Part D focuses exclusively on prescription drugs, though, whereas Advantage serves as a general replacement for all of the coverage found in Medicare Part A and Part B plans plus a few plan-specific extras.
You’ll want to carefully compare Advantage plans and Part D plans. Besides the wide variety of cost tiers and location-based availability, you’ll also want to note if your Advantage plan conflicts with Part D plans. Some Advantage plans are automatically cancelled upon your enrollment in a Part D plan, which would mean that you’d default back to Original Medicare Part A and Part B. That could substantially affect your overall insurance coverage. Consult with your plan administrators or your doctor before making any plan changes.
When to sign up
You have three opportunities to sign up for a Medicare Part D plan. You should take the first opportunity, which is called the Initial Enrollment Period. This period starts three months prior to your Original Medicare eligibility date and concludes four months past this date. If you miss this period, you can still enroll during the Annual Election period, which happens every calendar year between October 15th and December 7th.
If you miss both the Initial Enrollment Period and the Annual Election Period, you’re stuck with waiting for Medicare to open up one of its Special Election Periods. These periods are typically offered to help people with hardships such as the loss of prior insurance coverage. If you delay and have to enroll during a Special Election Period, you may be subject to health audits, late fees, and/or higher monthly premium fees that constantly increase over the life of your insurance plan.
What are my choices?
The Medicare Part D services listed in the preceding table are provided in all North Carolina counties. Your county of residence may provide additional plans and services. Contact your local Medicare office for additional details.
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.