The state of Vermont features 23 separate Medicare Part D prescription drug plans. These plans are sold and serviced by 12 different health care providers under the supervision of the federal government’s Medicare program. To qualify for one of these plans, you’ll first need to enroll in Original Medicare Part A and Part B. Once you’ve done that, you’re free to submit a Part D application. Usually you’ll be required to do so in person at the office of the company providing the plan. In some cases, you may be able to apply online.
You should apply immediately after you become eligible. Failure to do so may result in late penalties, higher monthly premium costs, and possible health audits that may prevent you from obtaining coverage.
Medicare Part D vs. Medicare Advantage
You might also be considering Medicare Advantage (sometimes called Medicare Part C) for your prescription drug assistance needs. While Advantage plans are similar to Part D in some respects (namely the fact that both plans are administered by third parties under the supervision of Medicare), they differ in terms of the drugs covered as well as the costs and the availability in your local area. Advantage plans are much broader than Part D plans, since they are designed to replace Original Medicare Part A and Part B, whereas Part D focuses exclusively on prescription drugs.
You should also be aware of the fact that some Advantage plans are incompatible with Part D. If you are enrolled in one of these plans and you subsequently enroll in Part D, you may lose your Advantage coverage and default back to Original Medicare Part A and Part B. You should always consult with your health plan administrator and/or your doctor before making any changes to your existing plan.
When to sign up
Medicare Part D’s Initial Enrollment Period starts three months prior to your Original Medicare eligibility date and concludes four months after that date. Your Original Medicare eligibility date is determined by your birth month and 65th birthday. If you miss the seven-month enrollment window from the initial period, you can still apply for Part D coverage during the Annual Election Period. This is a shorter window, and it runs from October 15th through December 7th each calendar year.
If you miss this window as well, your last opportunity to sign up for Part D will be during one of Medicare’s Special Election Periods. These periods are typically reserved for people who have extenuating circumstances that have prevented them from signing up earlier, so you should avoid waiting this long. If you delay your enrollment to a Special Election Period, you may be subject to late penalties, health audits, and higher monthly premium fees that may increase each month for as long as you are a Part D member.
What are my choices?
The Medicare Part D services listed in the preceding table are provided in all Vermont counties. Your county of residence may provide additional plans and services. Contact your local Medicare office for additional details.
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.