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 info@medicarenationwide.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 2023 can change to a tier 3 in 2024 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!
Thank you for being a valued client! 😊