The state of Massachusetts offers 23 Medicare Part D prescription drug plans which are furnished by 12 separate health care providers. Medicare Part D is a solid option if you’re struggling to pay your prescription drug costs and you’re over age 65. You’ll need to be enrolled in Original Medicare Part A and B in order to sign up for a Part D plan. Once you’re an official Medicare patient, you’ll need to complete either an online or a traditional paper application with the health care firm who is providing the Part D plan you’ve selected.
You should begin the application process as soon as possible, preferably on or near your Original Medicare eligibility date. If you delay your Part D enrollment, you may be subject to late fees, higher monthly premium costs, and possibly health audits that may affect your ability to obtain insurance coverage.
Medicare Part D vs. Medicare Advantage
In addition to Part D, Medicare Advantage (sometimes called Medicare Part C) offers prescription drug coverage. In fact, you may already be enrolled in an Advantage plan, since they typically offer the same or better coverage as Original Medicare Parts A and B. Like Part D, Advantage plans are offered by third-party insurance companies under the direction of Medicare itself. The scope and cost of the prescription drug coverage offered by Advantage plans varies considerably from that of Part D plans. Furthermore, some Advantage plans are incompatible with Part D, which means that if you enroll in a Part D plan while also enrolled in an Advantage plan, the Advantage insurance will become invalid and you will default back to Original Medicare Part A and B.
Be sure to consult with your Advantage administrator as well as the administrator of your proposed Part D plan before making any policy changes.
When to sign up
It’s critical that you sign up during Medicare Part D’s Initial Enrollment Period. This period begins three months prior to your Original Medicare eligibility date and ends four months after said date. Your Original Medicare eligibility date is based on your birth month and your 65th birthday. If you miss the seven month window granted to you by the Initial Enrollment Period, you can still sign up during the Annual Election Period. This period starts on October 15th and runs through December 7th each calendar year.
If you miss both of these periods, your final enrollment opportunity will take the form of a Special Election Period. These periods are intended to assist those with hardships such as a loss of prior insurance, so you should try to register during one of the prior periods. If you do not, you may face higher monthly premium payments, late penalties, and possible health audits.
What are my choices?
The Medicare Part D services listed in the preceding table are provided in all Massachusetts 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.