Medicare Part D provides prescription drug coverage to Medicare beneficiaries who live in Mississippi. These plans are provided through Medicare-certified private insurance companies. Medicare Part D launched in 2006, a direct result of the Medicare Modernization Act of 2003.
What Is Medicare Part D in Mississippi?
As in the rest of the United States, Medicare Part D provides prescription drug coverage in Mississippi. Private insurance companies offer Medicare prescription drug plans (PDPs), which is why benefits and costs vary according to the plan and provider you choose.
You have two PDP options:
- A standalone Part D prescription drug plan, which you can add to your Original Medicare coverage or a Medicare Advantage (MA) plan that does not cover prescriptions
- A Medicare Advantage Prescription Drug plan (MA-PD), which is an Advantage plan that covers prescription medications
Around two-thirds of Medicare beneficiaries choose Original Medicare (Part A, hospital insurance, and Part B, medical insurance). But a growing number are making the switch to a Medicare Advantage plan. These policies offer the same coverage you get with Original Medicare, but most offer additional benefits. In addition to prescription medications, this may include coverage for vision, dental, hearing aids, and more.
Not all MA plans offer the same benefits, so review your plan options carefully.
How Do You Get Medicare Part D in Mississippi?
If you are enrolled in Medicare Part A and/or Part B, you're eligible for Medicare Part D. Whether you can sign up for a particular Part D or MA-PD plan depends on whether you meet that individual plan's requirements. These vary, but basically come down to whether you live in the plan's service area.
When Can You Join a Medicare Part D Plan in Mississippi?
You may only join a Mississippi Part D plan during certain enrollment periods.
Your Initial Enrollment Period (IEP) lasts for 7 months. If you qualify for Medicare based on your age, your IEP begins 3 months before you turn 65 and ends 3 months after the month of your birthday. So, if your birthday is in June, your IEP begins on March 1 and ends on September 30. If you begin collecting Social Security benefits at least 4 months before you turn 65, you're automatically enrolled in Medicare Parts A and B. Everyone else has to sign up for Medicare.
Please note that Medicare Part D enrollment is never automatic. You must always choose and sign up for a Part D plan, regardless of your Social Security benefit status.
If you qualify for Medicare due to a disability, you're automatically enrolled in Medicare the 25th month you collect Social Security disability benefits. In this case, your 7-month IEP begins on month 22 and ends at the end of month 28.
During your Initial Enrollment Period, you may sign up for Original Medicare, join a Medicare Part D prescription drug plan, and/or enroll in a Medicare Advantage plan (with or without prescription drug coverage). If you sign up for Part B and are aged 65 or older, you may also join a Medigap plan at this time. Please note that you cannot have both a Medicare Advantage and a Medigap plan.
Additional Part D enrollment periods include:
- General Enrollment Period: If you miss your IEP, you can enroll in Part A and/or B during General Enrollment (January 1 through March 31). From there, you may sign up for a Part D or MA-PD plan from April 1 through June 30.
- Medicare Annual Enrollment Period: AEP occurs every year from October 15 through December 7. If you're currently enrolled in Medicare, you can sign up for prescription drug coverage during Annual Enrollment.
- Medicare Advantage Open Enrollment Period: From January 1 through March 31, beneficiaries who are currently enrolled in an Advantage plan may either change to another MA plan or switch back to Original Medicare. If the changes you can make during Open Enrollment cause you to lose your prescription drug coverage, though, you may also sign up for a Part D plan.
- Special Enrollment Period: Medicare understands that life changes may occur outside of defined enrollment periods. There are dozens of ways to qualify for a Special Enrollment Period. See the full list here.
What to Look for in a Medicare Part D Plan in Mississippi
To be sure you get the best plan for your unique needs and budget, review the Part D plan options in your area carefully. Start with the drug formulary. This is the list of drugs covered by the Part D plan. If the formulary does not include your prescriptions, it's probably not the best plan for you.
Part D plans also place covered medications on drug tiers. Which tier your medication is on indicates what you'll pay out-of-pocket for the drug. Lower tiers have the lowest prices. This is where you typically find generic and preferred brand name drugs. Drugs on higher tiers cost you more out-of-pocket.
When comparing Part D plan costs in Mississippi, look at the full cost of the plan, not just the monthly premium. This includes your annual deductible and coinsurance or copayment. You can estimate your copayment amount based on which tier the medication falls on.
If you have limited income or resources, you may qualify for Extra Help, a Medicare program that helps pay your prescription drug costs. Check eligibility on Medicare.gov here.
Do You Have to Have a Medicare Part D Plan in Mississippi?
Technically, you don't have to sign up for any part of Medicare. One way that Medicare encourages enrollment is by imposing late fees. If you delay signing up for Medicare AND you do not have creditable coverage elsewhere, you risk lifelong late penalties. (Creditablemeans that the plan is comparable to Medicare in terms of both cost and coverage.) If you go 63 days or more without creditable prescription drug coverage, expect to pay the Part D late penalty for the entire time you have Medicare drug coverage once you do enroll.
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