If you need assistance with your prescription drug costs and you live in Wisconsin, there are several options available to you through Medicare’s Part D prescription drug program. As of 2016, 13 different health insurance providers are offering a total of 25 separate Part D plans, with monthly premiums ranging from $18 to $139. To take advantage of Medicare’s Part D coverage, you’ll need to be enrolled in Original Medicare Part A or Part B. Once that’s done, you’ll need to apply to the Part D plan provider directly, either through a website form or a traditional paper form.
It’s in your best interest to enroll in Medicare’s Part D prescription drug plan as soon as you’re eligible. Delaying your enrollment could result in late penalties, various fees, and even higher monthly premiums over the life of your Medicare coverage.
Medicare Part D vs. Medicare Advantage
If you have Medicare Advantage (also called Medicare Part C) instead of Original Medicare Part A and Part B, there are some additional factors to consider. While Medicare Advantage and Medicare Part D share some similarities (both cover prescription drugs, though Part D does so exclusively while Advantage may offer drug coverage in addition to its other coverages), there are differences in the amount of coverage, its cost, and its availability in your area. Medicare Advantage is in some respects a replacement for Medicare Part A and Part B, whereas Part D only focuses on prescription drugs.
Additionally, enrollment in Part D may void your existing Medicare Advantage coverage, which would then force you to return to Original Medicare Part A and Part B for your hospital and general health coverage. Be sure to consult with the administrator of both your Medicare Advantage plan and your proposed Part D prescription drug plan before you make any policy changes. Failure to do so might invalidate some or all of your health insurance coverage.
When to sign up
When it comes to signing up for Medicare Part D prescription drug coverage, earlier is better. The Initial Enrollment Period is a seven-month window that falls around your Original Medicare eligibility date (which is based on your birth month and your 65th birthday). You can sign up for Part D as early as three months prior to your Original Medicare eligibility date and as late as four months after that date.
If you miss the Initial Enrollment Period, be sure to sign up during the Annual Election Period, which occurs between October 15th and December 7th each calendar year. If you miss that period as well, your last chance will be during a Special Election Period that happens at various times throughout the year. Medicare provides these periods to assist patients who have lost their previous insurance or who are undergoing other hardships that prevented a timely enrollment application. Be aware, though, that after the Initial Enrollment Period, you may be subject to higher monthly premium fees for your Part D plan as well as health audits that could affect your ability to get coverage.
What are my options?
The Medicare Part D services listed in the preceding table are provided in all Wisconsin 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.