As of 2018, more than 646,000 people were enrolled in Medicare in Arkansas alone according to the Kaiser Family Foundation (KFF). If you’re already enrolled or you’re thinking about the process, finding out about Medicare Part D is essential. Medicare Part D is available to everyone in Arkansas who is also enrolled or eligible to enroll in Medicare.
What Is Medicare Part D?
Medicare Part D ensures that those living in Arkansas have access to prescription medication covered by health insurance. When you sign up for Original Medicare, you will be enrolled in Part A and Part B. Part A covers expenses related to hospital care and emergency visits. Part B covers doctor visits and other medical procedures that do not require hospitalization. Enrollment in Part D is not automatic so if you want coverage for prescription medication, you will have to manually enroll.
Medicare Part D is offered by private companies contracted by Medicare to provide insurance for prescription medications. According to KFF, over 465,000 people in Arkansas have registered for this prescription coverage. It’s important to note that Part D only applies to prescription medication, and generally doesn’t cover over-the-counter (OTC) medications. OTC medications are typically an out-of-pocket expense for anyone who purchases them.
What Medicare Part D Plans Are Available in Arkansas?
There are two ways to obtain Medicare Part D prescription drug coverage in Arkansas. You can choose to stick with Original Medicare Parts A and B and purchase a stand-alone Part D plan that covers your prescription medication. Or, you can choose to enroll in a Medicare Advantage plan which rolls in your Part A and B benefits, as well as other benefits, including prescription drug coverage.
Whether you purchase a Part D Prescription Drug Plan or a Medicare Advantage Prescription Drug Plan, you will still have a monthly deductible. With Original Medicare, you will have Part A, B, and D whereas Medicare Advantage, also known as Part C, is an all-in-one option. However, even with Medicare Advantage, you will still pay a separate Part B deductible.
In 2023, there are 23 stand-alone Part D plans available for residents of Arkansas. Plus, the lowest costing plan had a monthly premium of $7.60. And, around 70% of those residents with Part D coverage choose the stand-alone option for prescription drug coverage.
Some Medicare Advantage plans with prescription drug coverage have a premium as low as $0 a month but you will still have a Medicare Part B premium to pay. CMS reports that there were 54 Medicare Advantage plans available in Arkansas as of 2018. Around 30% of those residents with prescription drug coverage plans sign up through a Medicare Advantage Prescription Drug Plan.
Enrolling in Medicare Part D
Enrolling in Medicare Part D is simple and straight forward. You are eligible to enroll if:
- You have signed up for Medicare Part A and/or Part B
- You reside in the service area of a Medicare Advantage Prescription Drug Plan or a Medicare Prescription Drug Plan.
The essential thing to keep track of is the time during which enrolling is possible. There are several different times to enroll.
- Initial Enrollment Period. This is the time when you are first eligible to enroll in Medicare. This includes the three months before you turn 65, the month of your birthday, and the three months after you turn 65. If you are eligible to enroll in Medicare early due to a disability, you can enroll three months before your 25th month of disability benefits, during the 25th month, and for three months following.
- Annual Election Period. If you wait to enroll in Medicare Part D until after you’re first eligible, you can enroll during the Annual Election Period. This is also known as the Open Enrollment Period for Medicare Advantage and Medicare Prescription Drug Coverage. This window goes from October 15 to December 7 every year. In addition to signing up for a stand-alone Part D plan, you can also sign up for a Medicare Advantage drug plan, switch Medicare plans if already enrolled, or disenroll from a Medicare prescription drug plan.
- Medicare Advantage Open Enrollment Period. If you choose to sign up during the Medicare Advantage Open Enrollment Period, you can do so during January 1 through March 31. During this time, you can switch Medicare Advantage plans, or you can disenroll from your Medicare Advantage plan and return to Original Medicare and purchase a stand-alone Medicare Prescription drug plan.
- Special Election Period. If you have a qualifying life situation, you can use a Special Election Period to change your health insurance coverage. Qualifying life events include moving out of a plan’s service area, no longer qualifying for Medicaid, or your plan no longer offering insurance.
Do I Need Medicare Part D Prescription Drug Coverage?
Medicare Part D prescription drug coverage will ensure that you don’t have to pay full price for prescription medication that you need to take on a daily basis. Without this insurance, you’ll be responsible for the full cost of your medications.
If you wait until after your qualifying time to get Medicare Part D prescription coverage, you could end up paying an additional late fee for the life of your policy, even though signing up is optional.
Before signing up, make sure you look through the list of medications your preferred plan covers. This list is called a formulary. If your medication is not on the formulary, you’ll need another plan that covers it. These lists can change, and if they do, the insurance company will alert you to changes that have occurred.
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