Eligibility For Medicare Part D and Medicare Part D Plans

Medicare Part D isn’t just for an Americans who age 65 or older, if you meet some certain other criteria, you can also be Eligible for Medicare part D, if you are Eligible for Medicare then you are Eligible for Part D.

Here in this Article, you will get all the Details you Need to know about the eligibility for
Medicare Part D.

Who is Eligible for Part D Medicare?

You Must qualify in one of the Following, to be eligible for Medicare Part D:

  • If you are age is 65 & you can enroll in Medicare Part A and Medicare Part B.
  • If you have received a Social Security Disability payment for at-least 2 years. Then the waiting period for Medicare is waived if you have received a Diagnosis for (ALS) Amyotrophic Lateral Sclerosis. With these conditions. you are eligible to receive the first month Disability Payment.
  • If you have received a diagnosis of (ESRD) End Stage Renal Disease or with Kidney Failure and you Need to have a Kidney Transplant or Dialysis, Employees Railroad with ESRD Can contact the social security to find out about Eligibility for Medicare with number 800-722-1213.
  • Children who are under age 20 With End Stage Renal Disease (ESRD) Can qualify if thy have at-least one parent who are eligible for Social Security Benefits.

Eligibility of Medicare Part D in more Details:

Who Age 65 or Older

For Most of the People, People will first become eligible to Enroll in a Medicare Part D from 3Months before you are 65th birthday to 3 Months after you are Birthday.

 You need any help with a plan, Call to the provider of the Medicare Part D, or Call 800-Medicare for Help with a plan you have chosen to enroll online.

Medicare Part D Qualifying Disability

People who are not 65 years but have a Disability, this will qualify you to receive a Social Security or a Railroad Retirement Disability Benefits, you will be eligible for Medicare Part D 3 months before the 25th month of Benefit payments until 3 months after you are 25th month of receiving the benefits.

Also Read : Medicare Part C coverage

When can you enroll in Medicare Part D:

Generally, there are no rules when you can and cannot enroll in a Medicare part D plan.

Enrollment for Medicare part D:

Medicare Part D Enrollment period usually starts each year from 1st April to 30th June, if you have already enrolled in coverage for Medicare Part A and Medicare Part B and if you want to add Medicare part D, the Best time to enroll is 1st April to 30th June, to change your Medicare Part D plans, you need to want for open enrollment to come around again.

What is Open Enrollment for Medicare Part D?

The Open enrollment for Medicare will start from October 15th to December 7th, if you are interest in eligible, During this time you may:

  • Enroll in a plan which has or provides prescription Coverage.
  • Enroll if you want to change you are Medicare Part D Plans.
  • Drop Medicare part D Coverage, which may be result in Penalties if you have no Prescription Coverages.

Form January 1st to March 31st, People may drop or change you are Medicare Advantage Plans with Part D Coverage, or you May Join Original Medicare Part A and Part B if you are interested During this time.
You Cannot Join a Medicare Part D Plan during this time if you are having original Medicare.

Penalty for Late Enrollment (Medicare Part D)

When you Become Eligible for Medicare Part D it is good to enroll or sign up for a Medicare Part D even if you are not taking any Prescription Medications, Medicare adds a 1% permanent late enrollment penalty if you don’t enroll withing 63 days of you are initial eligibility Period.

Medicare penalty rate is calculated based on the National Premium rates for the present year which is Multiplied by the number of months you did not enroll when you were Eligible to Medicare, if you wait for you are extra penalty payment will be on based how long you dint not have Medicare part D Coverage. This can Add more or goes up.

Note: This is based on Premium changes each year to year, if the Premium Goes up or down, you are Penalty also changes too.

If you already have a Medicare Advantage Plan, and when you turn 65 years old, still you need to have a Medicare Part D Coverage.

IF you want to avoid the penalty, if you have Medicare “Creditable Coverage” From another plan, this say you have a Drug coverage that is at least equal to the Part D Coverages from another source,

Buy a Medicare Part D plan at low cost, when you become Eligible to Part D, Since the penalty add to your premium Cost, if you need Different coverage, you can change plans during Each open Enrollment time if you Need to Get different Coverage.

 Medicare Prescription Drug Coverage Options?

Prescription Drug plans Part D are offered through private insurance, which is Availability and varies by state.

Medicare Helps to compare plans in you are area which you are looking ahead to 2023.

  • Medicare Part C Advantage Plans:
     – This Medicare Advantage Plan can take care off all you are Medical Needs (Medicare Part A, Medicare Part B and Medicare Part D) which including Dental coverage, vision coverage, these premiums might be higher & you need to go to network doctors and pharmacies.
  • Medicare (Medigap) Supplement:
    – Medicare Medigap plans Helps pay for some or all out of Pocket cost, which is like, Copays and Deductibles. There are almost 10 plans available. You can choose or compare the rates and coverage with you are original Medicare Coverage Gap & Premiums, Choose the Best Option which gives you best Option which gives maximum benefits at the lowest rates.
  • Medicare Part D:
    – Medicare Part D Covers Prescription Medications for the outpatient services.  Based on Medicare rules All the plans have to offer some basic level of Drug coverage, if you are Doctor wants a Drug covered that is not part of that plan list, they will need to write an appeal letter, Individual each nonformulary Medication Coverage Decision.

Also Read : Medicare Advantage Plans

Note: The New Medigap Plans Do Not Cover Prescription Drug like Deductibles and Copays, also you cannot buy a Medigap Insurance if you already have a Medicare Advantage Plan.

Chose a plan on what is covered to give you the Most Benefit, if you take Specialty or Expensive Medications or have a Chronic Condition That requires a Medications.

Best tips for Choosing a Medicare Part D Plan:

Chose Medicare part D plan Carefully, Because the plan you choose and if you want to change your current plan each year to year, you Need to stay in a current plan the entire year, so again chose the Plan Carefully.

  • You need to choose a plan based on you are overall Health and Medication Needs.
  • Ask a Navigator for Help with the good option, important where you live, whereas if you live in Multiple states during the Year might Affect the available plans.
  • Premiums, Deductibles, and copay can vary with you are plans, Review what is not covered, lower the cost of noncovered items and then you need to compare that to lower premiums to see which is better option for you.
  • Here you can add Medigap Coverage for Out-of-pocket costs if you have an Original Medicare with Medicare part D Coverage.
  • Make Sure if you have Doctors and Pharmacies you like, they are listed in the Network of you are plan.

Medicare part D Helps to pay for your Prescription Drugs which are not covered by Original Medicare part A and Part B, You can also chose a private Medication plans that will add to your Original Medicare Coverage, or you can chose a Medicare Advantage Part C Plan With Drug Coverage, These plans may cover Dental and Vision Benefits. But keep in your mind that the Premiums may be Higher, and you might Have to Go with in Network Doctor and Pharmacies.

Note: There is a Permanent Penalty added to you are Premium if you do not choose a Drug plan or don’t have you are Drug Coverage when you are Eligible.

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