If you’re turning 65 and living in Colorado, it’s time to learn about Medicare Part D. This is an essential part of your health insurance coverage, and there are certain times when you can apply for it. It’s necessary to know all the facts, so you’ll be ready to sign up for this part of your health coverage when you become eligible.

Medicare Part D coverage

For Medicare beneficiaries that are turning 65 or losing their employer health benefits, you will need to purchase a prescription drug plan. There are two different paths for getting your prescription drug coverage. You can apply for a stand-alone prescription drug plan known as Part D that will work alongside your Original Medicare benefits. These plans are available to you through private insurance companies that Medicare contracts with to provide coverage. These stand-alone plans are available for those enrolled in Original Medicare only.

If you have or are thinking about enrolling in a Medicare Advantage plan, you’ll want to select a Medicare Advantage plan that includes prescription drug coverage. These all-in-one Medicare Part C plans are offered by health insurance companies contracted by Medicare, as well. Medicare Advantage plans have all of your Medicare benefits – Part A, B, and D – included in one plan. As with Original Medicare, you will still pay a monthly premium for Part B in addition to your Medicare Advantage premium.

If you enroll in a Medicare Advantage plan that includes drug coverage, you may not purchase a separate stand-alone prescription drug plan. If you do, you will be disenrolled from the Medicare Advantage plan and revert back to Original Medicare.

Medicare Part D enrollment in Colorado

When you become eligible for Medicare in Colorado, you can sign up for Medicare Part D during this time as well. This is known as the Initial Enrollment Period, and it starts three months before you turn 65, continues through the month of your birthday, and ends three months afterward. This is the seven-month window when you need to sign up for your Medicare benefits or you may be faced with penalty charges.

During the Initial Enrollment Period, you can choose to have Original Medicare alongside a stand-alone Part D plan or choose a Medicare Advantage plan that provides many additional benefits including prescription drug coverage. While prescription drug coverage is optional, it is highly recommended. If you do not enroll for it when you are first eligible and choose to do so later, you may be penalized with a late fee for the life of your Part D policy.

The Annual Election Period is for those who want to change from Original Medicare to Medicare Advantage or switch from Medicare Advantage back to Original Medicare and purchase a stand-alone Part D plan. Regardless whether you have Original Medicare or Medicare Advantage, you can change your plans from October 15 to December 7 each year. If you have Medicare Advantage and you only want to change Medicare Advantage plans, you’ll be able to do so during the Open Enrollment Period, which runs from January 1 through March 31.

Special Election Period occurs when you have a life change such as moving outside of the coverage area or losing coverage through no fault of your own. If this happens, you’ll be able to choose a new plan with no penalty.

Medicare Part D choices in Colorado

When you choose a stand-alone Medicare Part D plan or Medicare Advantage Prescription Drug plan, it’s important to review the formulary to see their list of covered medications. Each insurance provider has a different set of medications they cover. Be sure that your medication is on the list before you sign up for coverage.

Formularies can change, and if this happens, your insurance company will notify you. If they took your drug off the list, they’ll cover it for the rest of the coverage year. After that, you’ll need to change insurance plans if you want to keep your prescriptions covered through insurance. Keep in mind that each plan will also have a different premium, as well. It’s important to shop around so you can find an option that has your prescriptions and fits your budget.

Even if you don’t need or take any prescription drugs right now, it’s smart to get in on a Medicare Part D plan early. You’ll not only avoid late penalties for not signing up, but you’ll have coverage ready and waiting for when you need it.

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