If you need assistance with your prescription drug costs and you live in Colorado, there are several options available to you through Medicare’s Part D prescription drug program. As of 2016, 13 different health insurance providers are offering a total of 24 separate Part D plans. Monthly premiums for these range from $18 to $140. To take advantage of Medicare’s Part D coverage, you’ll need to be enrolled in Original Medicare Part A or Part B. Once that’s done, you’ll need to apply to the Part D plan provider directly, either through a website form or a traditional paper form.
It’s in your best interest to enroll in Medicare’s Part D prescription drug plan as soon as you’re eligible. Delaying your enrollment could result in late penalties, various fees, and even higher monthly premiums over the life of your Medicare coverage.
Medicare Part D vs. Medicare Advantage
Medicare Part D isn’t the only Medicare plan that offers prescription drug assistance. Some Medicare Advantage plans (also called Medicare Part C) offer it as well, though the scope and cost of coverage varies considerably from Part D plans and formularies. While Medicare Part D focuses exclusively on prescription drug benefits, Medicare Advantage plans provide the same (and in many cases, superior) coverage as Original Medicare Parts A and B.
We recommend carefully researching your coverage and cost options by comparing Medicare Part D plans with Medicare Advantage drug plans. If you are already enrolled in an Advantage plan but you think that a Part D plan might better suit your needs, you first need to make sure that signing up for Part D will not affect your Advantage plan. In some cases, Part D enrollment will cancel an existing Advantage plan and roll you back to Original Medicare Part A and Part B coverage. This essentially means that your entire Medicare coverage suite could be impacted by your decision to switch prescription drug plans.
Prior to making any plan changes, be sure to consult with your Advantage plan provider as well as the administrator of your prospective Part D plan to ensure that you maintain the coverage you need.
When to sign up
Signing up on time is critically important when it comes to affordable Medicare Part D prescription drug coverage. There are three enrollment periods offered through the year, though it’s in your best interest to take advantage of the Initial Enrollment Period. This is a seven month window that begins three months prior to your overall Medicare eligibility date. If you’re wondering about that date, it is calculated based on your birth month and your 65th birthday. The Initial Enrollment Period for Part D extends four months past your Medicare eligibility date.
If you miss this seven month window, you may apply during the Annual Election Period, which begins on October 15th and concludes on December 7th of each year. Keep in mind that you may be subject to insurance or health condition audits as well as additional fees if you opt for the Annual Election Period instead of the Initial Enrollment Period.
Finally, Medicare offers a Special Election Period for people who miss the first two periods. Special Election Periods may occur at various times throughout the year and are intended to assist those with extenuating circumstances such as the loss of insurance or prior drug coverage. You should contact Medicare directly at 1-800-633-4227 to find out if you qualify for a Part D Special Election Period.
What are my choices?
The Medicare Part D plans in the preceding table are provided in all of Colorado’s counties. Your particular county may feature additional plans or services. Contact your local Medicare office for further information.
Plans are subject to change as contracts are finalized.
Includes contracts/plans as of April 22, 2016. The data does not reflect information for employer-sponsored plans, Part B-only plans, or plans not offering a Part D drug benefit.