Maryland residents have 21 options when it comes to Medicare Part D prescription drug plans. These plans are administered by 12 separate health care providers under the direction of the federal government. Part D eligibility requires that the patient already be enrolled in Original Medicare Part A and Part B. After that prerequisite is met, the patient must fill out an application form for the Part D plan desired, either via the website of the company providing the plan or via a traditional paper application form.
Part D applicants are encouraged to begin the process as soon as possible so as to avoid possible late fees, health audits, and increased monthly premium prices.
Medicare Part D vs. Medicare Advantage
If you are already enrolled in a Medicare Advantage plan, or you’ve researched prescription drug costs and found that some Advantage plans cover them, there are several additional factors to consider. First, while Medicare Advantage (often called Medicare Part C) and Medicare Part D both cover prescription drugs, only Part D does so exclusively. Medicare Advantage plans may cover some prescription drug costs, but Advantage typically exists to replace Original Medicare Part A and Part B coverage and usually does not offer the full range of drug coverage options available to Part D members.
Aside from the price, availability, and coverage option differences between Advantage and Part D, you should also know that some Advantage plans are not compatible with Part D. If you happen to be enrolled in one of these plans and you then enroll in a Part D plan, your Advantage plan will be discontinued and you will revert back to Original Medicare Part A and Part B coverage. Be sure to consult with your current insurance administrator if you are considering a Part D application and you are already enrolled in Medicare Advantage.
When to sign up
After you’ve picked your Part D plan, you’ll need to sign up as soon as possible. The Initial Enrollment Period begins three months before your Original Medicare eligibility date and ends four months after said date. Your Original Medicare eligibility date is based on your 65th birthday and your birth month.
If you miss the initial sign-up period, you can sign up during the Annual Election Period, which runs from October 15th to December 7th each year. If you miss this period as well, your last opportunity to sign up for Part D will occur during one of Medicare’s Special Election Periods. These periods are designed to assist those with extenuating circumstances or hardships (such as the loss of prior insurance coverage), so it is best if you do not wait until the last minute and instead take full advantage of the previously mentioned Initial Enrollment Period. Signing up early means that you will avoid possible monthly premium increases, late penalties, and health audits that may affect your ability to get insured.
What are my choices?
The Medicare Part D services listed in the preceding table are provided in all Maryland 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.