About Medicare Prescription Drug Plans

How does Medicare drug coverage work?

Medicare drug coverage helps pay for prescription drugs you need.  Even if you don’t take prescription drugs now, you should consider getting
Medicare drug coverage.  Medicare drug coverage is optional and is offered to everyone with Medicare.  If you decide not to get it when you’re first
eligible, and you don’t have other creditable prescription drug coverage (like drug coverage from an employer or union) or get Extra Help, you’ll likely
pay a late enrollment penalty if you join a plan later.  Generally, you’ll pay this penalty for as long as you have Medicare drug coverage.  To get Medicare drug coverage, you must join a Medicare-approved plan that offers drug coverage.  Each plan can vary in cost and specific drugs covered.
Visit Medicare.gov/plan-compare to find and compare plans in your area.

There are 2 ways to get Medicare drug coverage:

1. Medicare drug plans.  These plans add drug coverage to Original Medicare, some Medicare Cost Plans, some Private Fee-for-Service plans, and Medical Savings Account plans.  You must have Part A and/or Part B to join a separate Medicare drug plan.
2. Medicare Advantage Plans or other Medicare health plans with drug coverage.  You get all of your Part A, Part B, and drug coverage, through these plans.  Remember, you must have Part A and Part B to join a Medicare Advantage Plan, and not all of these plans offer drug coverage.

In either case, you must live in the service area of the plan you want to join.

If you have employer or union coverage
Call your benefits administrator before you make any changes, or sign up for any other coverage.  If you sign up for other coverage, you could lose your employer or union health and drug coverage for you and your dependents.  If this happens, you may not be able to get your employer or union coverage back.  If you want to know how Medicare drug coverage works with other drug coverage you may have, refer to page 84 in the 2021 Medicare and You Handbook.

When can I join, switch, or drop a plan?
You can join, switch, or drop a Medicare drug plan or a Medicare Advantage Plan with drug coverage during these times:
• Initial Enrollment Period.  When you first become eligible for Medicare, you can join a plan.
• Open Enrollment Period.  From October 15 – December 7 each year, you can join, switch, or drop a plan.  Your coverage will begin on January 1 (as long as the plan gets your request by December 7).
• Medicare Advantage Open Enrollment Period.  From January 1 – March 31 each year, if you’re enrolled in a Medicare Advantage Plan, you can switch to a different Medicare Advantage Plan or switch to Original Medicare (and join a separate Medicare drug plan) once during this time. 

If you have to pay a premium for Part A and enroll in Part B for the first time during the General Enrollment Period, you can also join a plan from April 1 – June 30. Your coverage will begin on July 1.

from 2021 Medicare and You Handbook (pages 75 and 76)

For Croft Insurance Clients

To make the Annual Enrollment Period as pain and stress free as possible, we provide the following service:

1.  By the end of September, you should receive our Annual Enrollment Update communication.  If we have an active email account on file for you, we will send this communication via email.  Otherwise, we will mail to the address we have on file.

2.  Return to us as soon as possible the form on which you update your prescriptions (and certainly by the return date indicated in the letter we sent).

3.  Once we receive your updated prescription list, we will review your prescriptions against the various plans offered in our area.  If it looks like the plan in which you are currently enrolled is the most favorable financially, we will call you and let you know our recommendation to stay with that plan.  If it looks like another plan would be more favorable, we will email or mail information about the recommended plan with a comparison to your current plan.  Once you decide between the two, we will get you enrolled in the new plan, if that’s what you would like to do.

4.  And then you’re all finished.