In Michigan (and every other state), Medicare Part D plans are offered by private insurers contracted with Medicare to provide prescription drug coverage. You can either enroll in a standalone Medicare Part D plan, or in a Medicare Advantage Prescription Drug (MA-PD) plan. If you are signed up for Medicare Parts A and B, also known as Original Medicare, or a Medicare Advantage plan without drug coverage, you need to sign up for Part D to obtain prescription drug coverage.
Medicare Advantage plans are also provided by private insurance companies, but must provide the same coverage as Original Medicare. Most Medicare Advantage (MA) plans offer additional benefits, with dental, vision, and prescription drug coverage being common add-ons. But remember, not all MA plans include drug coverage. If you want Parts A, B, and D through MA, you need to make sure the plan you choose includes prescription coverage.
Signing up for Medicare Part D in Michigan
If you are eligible for Original Medicare and enrolled in Part A and/or Part B, then you are able to sign up for Medicare Part D in Michigan. There are specific period you can enroll in Medicare:
- Initial Enrollment Period (IEP): Beginning three months before the month of your 65th birthday and lasting for the following three months, this seven-month period is the first time you can sign up for any Medicare services.
- Annual Enrollment Period (AEP): From October 15 through December 7, current Medicare beneficiaries can switch to a new MA plan, sign up for a new Part D plan, or switch between Medicare Advantage and Original Medicare.
- Following the General Enrollment Period (GEP): Immediately after the GEP (January 1 to March 31), you can sign up for a Medicare Part D plan from April 1 through June 30.
- Medicare Advantage Open Enrollment Period (OEP): For current Medicare Advantage beneficiaries, you can switch between MA plans or return to Original Medicare from January 1 through March 31. If you lose prescription drug coverage due to any changes during this time, you may sign up for a Part D plan.
If you miss these enrollment periods, you must meet qualifying circumstances to sign up during a Special Enrollment Period (SEP). For a list of special circumstances, check here.
Choosing Part D prescription drug coverage in Michigan
To find the best Medicare Part D plan for you, it is important to balance your healthcare needs with your budgetary requirements. Since Part D plans are offered by private insurance companies, your costs and coverage vary depending on both the company and plan you choose.
Make sure to check a plan's formulary. This is the tiered list of medications a plan covers; the higher the tier, the higher the cost for the medication. If your medications are not on this list, or in a cost-prohibitive tier, look for another plan.
Remember, even if your premium or deductible are low, medication in higher tiers with higher copays can easily offset those savings. If income and resources are limited, you may qualify for the Medicare program designed to help cover prescription drug costs, Extra Help.
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