The state of New Mexico offers 24 Medicare Part D prescription drug plans in conjunction with the federal government and 13 third-party health insurance providers. To qualify for one of these plans, you must first sign up for Original Medicare Part A and Part B. Once you are enrolled in Original Medicare, you may then apply to Part D prescription drug plan of your choice. You should check the providing company’s website for an online application. If they don’t offer one, you’ll need to visit the company in person and submit a traditional paper application.
You should apply for your Part D coverage as soon as possible after you become a Medicare member. Delaying your application can cause you to pay late fees. Not only that, but it could also lead to higher monthly premium fees and even health audits that may affect your ability to secure coverage.
Medicare Part D vs. Medicare Advantage
You might also consider a Medicare Advantage plan for your prescription drug needs. While Advantage (also called Medicare Part C) is intended to replace Original Medicare Parts A and B, some plans do feature additional prescription drug coverage. You’ll need to shop around your local providers to see if an Advantage plan or a Part D plan is the best fit for your particular needs. Like Part D plans, Advantage plans are sold and serviced by third-party health care providers. Costs and availability will vary, and it’s also worth noting that some Advantage plans are not compatible with Part D plans. This means that if you are enrolled in an Advantage plan and you subsequently enroll in a Part D plan, your Advantage insurance will be canceled and you will revert back to Original Medicare Part A and Part B.
You should always consult with your health plan administrator and your doctor before making any changes to your coverage.
When to sign up
You should sign up for your Medicare Part D prescription drug plan as soon as you’re eligible. The Initial Enrollment Period begins three months prior to your Original Medicare eligibility date (which is derived from your birth month and your 65th birthday). This period ends four months after your Original Medicare eligibility date, giving you a seven-month window in which to apply.
If you miss the first window, you may try again during the Annual Election Period which starts on October 15th and continues through December 7th of each calendar year. If you miss this period as well, you may petition Medicare for enrollment during one of its Special Election Periods. These occur infrequently throughout the year and are intended to assist those with special needs like the unexpected loss of prior insurance. Delaying your Part D application to a Special Election Period may result in late fees, higher month premiums, and possible health audits.
What are my choices?
The Medicare Part D services listed in the preceding table are provided in all New Mexico 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.