Medicare Part D in Mississippi

Medicare Part D is the insurance policy that helps pay for prescription drugs. There are many different plans. The plans are administered by private insurance companies, but must be approved by Medicare. We can help you with information about Part D Rx plans.

When you become eligible for Medicare Part B, you are also eligible to enroll in a Part D prescription plan. This is your initial open enrollment period. You have 7 months. Three months before your Part B effective date, the month of your Part B effective date, and three months after your Part B effective date. If you do not enroll in a plan when you are entitled to, and decide to enroll later, your premium may be accessed a penalty. The penalty is 1% per month for every month you were entitled to the Part D but did not have it. And you will have to wait until the Annual Enrollment Period unless you are entitled to a Special Enrollment Period.

You may enroll in these plans when you become eligible for Medicare. You may not make changes in these plans except during the annual enrollment period. The AEP begins on October 15th and ends on December 7th.

If you have other prescription drug coverage that is considered at least as good as Medicare, or "Credible Coverage", you may not be penalized for not enrolling when your Part B begins. If you lose this "Credible Coverage", like a group retirement plan for example, you may be entitled to a Special Enrollment Period. You generally have a 63 day period after you lose your group coverage in which to enroll.

Here are some definitions of terms that might be helpful in understanding Part D:

• Premium - The amount you pay each month for the insurance.
• Deductible -The amount you have to pay before the insurance begins to pay its share. The deductible cannot be over $325 in 2013. Not all plans have deductibles, but deductibles are not necessarily a bad thing, because sometime plans with deductibles can be cheaper. It depends on your prescriptions and the copays of the plan.
• Co-pay - This is how much you pay for your prescription. It is your share.
• Tier - Drugs are ranked in "tiers" by how expensive they are. This determines the co-pay. For example:
• Tier 1 is a generic drug. It has the lowest co-pay.
• Tier 2 is preferred brand name.
• Tier 3 is non-preferred brand name.
• Tier 4 is specialty drugs. It is the most expensive.

There are three stages of coverage for Part D Prescription insurance.

• The initial coverage. During this stage you pay your share, usually co-pay, and the plan pays the rest. When the total paid by you and the plan reaches $2970, you have reached your initial coverage limit. You then enter the “gap”. Your Part D will pay most of the cost during the initial coverage stage.
• The coverage “gap”, or “doughnut hole” is the second stage of coverage. During this coverage gap, you must pay the total discounted cost of the drugs. In 2013, brand name drugs in the gap will be discounted by 50%. When the total you have paid for the year reaches $4750, you enter the catastrophic coverage stage.
• After your total out of pocket cost for the year reaches $4750, you will enter the catastrophic phase of coverage and only pay a small co-payment for your prescriptions (about 5% of the cost).

Extra assistance to help you with the drug cost is available for people with limited incomes. We can assist you to see if you qualify, or you may call social security at 1-800-772-1213 to see if you qualify. TTY users should call 1-800-325-0778.