We hope you find this Medicare Part D FAQ useful. It was created out of necessity as Part D carriers do not allow agent handling. If your question is not listed, please email us at firstname.lastname@example.org.
Your agent should have discussed your deductible amount with you. In the event you still don’t know, most plans have a deductible of $505. This deductible is only required to be met for tier 3 and 4 medications. If your medications are tier 1 and 2, you will only owe a copay and not have to meet the deductible first. In the event you do get a tier 3 or 4 medication some time in the year, be prepared to meet your deductible first before what you owe turns into a copay.
Example, you get a medication that retails for $600. You go to the pharmacy to fill your medication. You will owe the first $505(in this example) and the additional $100 will be owed in the form of a copay. For the remainder of that year, you will only owe the set copay amount since your deductible has been satisfied.
If you need to find out what your deductible is, call the carrier number below or email us at email@example.com
Drug plans are unique to each individual. We use medicare.gov to find the right plan for our clients. Medicare has a wonderful algorithm that matches up your drugs and pharmacy and matches it with all 20+ plans available in your state. It then sorts it by lowest annual out of pocket to highest. This takes into account copays, deductibles, and premium for the year. You literally cannot find a cheaper, better drug plan using this method!
If you get a medication during the year, you are at the mercy of how that drug matches with the formulary of your plan. This is the same for all plans including employer/individual plans. In the event that the new medication isn’t on the formulary, there’s a form your doctor can fill out and fax in to the carrier to get it added. For access to this form, please call the carrier directly as the form is unique to each carrier.
You will not be able to change drug plans until the enrollment season from October 15th to December 7th for a January 1st effective date of the following year.
Yes! Every year, new plans are added, plans are taken away, formularies change, and the relationship with the drug carrier and pharmacy change. Some examples are; a tier 1 medication in 2022 can change to a tier 3 in 2023 for the same drug plan or, what was once a preferred pharmacy, might change to a standard pharmacy or not be an accepted pharmacy at all.
We will reach out to you every year via email and text to set an appointment with one of our Part D specialists the first week in October. Be on the lookout!