An important part of healthcare is making sure your prescription drug costs are manageable. This is why, if you're ready to enroll in Medicare, it is important to understand Medicare Part D
Learning about Medicare Part D in Nebraska
Costs for prescription medications can add up quickly, easily reaching thousands of dollars a year. This is where Medicare's prescription drug coverage, Medicare Part D, helps. In Nebraska, you can get drug coverage by purchasing a standalone Part D plan in conjunction with Original Medicare (Parts A and B), or a Medicare Advantage Prescription Drug (MA-PD) plan. An MA-PD plan provides Medicare Parts A, B, and D through a single policy.
Both standalone and MA-PD plans are offered by private insurers contracted with Medicare in Nebraska. While an MA-PD plan may not have you pay a Part D premium, you will still have a monthly premium for the Medicare Advantage plan. You cannot have both an MA-PD plan and a standalone Part D plan.
When can you get Medicare Part D coverage in Nebraska?
You are eligible for Medicare Part D as soon as you sign up for Original Medicare. It is important to note that, unless you started getting Social Security benefits at least four months before your 65th birthday, you must enroll yourself in Medicare Parts A and B. Enrollment in Medicare Part D is never automatic.
Medicare Part D enrollment periods in Nebraska
There are specific periods you can sign up for Medicare Part D in Nebraska:
- Initial Enrollment Period (IEP): Starting three months before the month of your 65th birthday and lasting through the following three months, your IEP is always a total of seven months. Once you sign up for Parts A and/or B, you can sign up for Part D.
- Following the General Enrollment Period (GEP): The GEP lasts from January 1 through March 31 and you can sign up for Original Medicare if you missed your IEP. Immediately following, from April 1 to June 30, you can sign up for Part D.
- Annual Enrollment Period (AEP): Between October 15 and December 7, current beneficiaries can change their coverage, including enrolling in a Part D plan.
- Medicare Advantage Open Enrollment Period (OEP): Only for MA beneficiaries, the OEP lasts from January 1 through March 31. You can switch between MA plans or return to Original Medicare. You may also sign up for Part D if changes cause you to lose your drug coverage.
Outside of these times, you may qualify for a Special Enrollment Period (SEP) if you experience special circumstances, such as moving outside your coverage area. You can find a full list of qualifications here.
Comparing Part D coverage in Nebraska
Since both Part D and Medicare Advantage plans are provided by private insurers, costs vary depending on the company and plan you choose. And, while cost is important, the biggest factor to consider is a plan's drug formulary. A formulary is the tiered list of medications a plan covers, with drugs in higher tiers costing more. If your prescriptions aren't in the formulary, it isn't the right plan for you.
In terms of cost, you want to make sure your needs are met without going over your budget. Be sure a lower monthly premium is not masking other, higher out-of-pockets costs. If resources are limited, you may qualify for Extra Help, a program that helps cover the cost of medication.
Is Medicare Part D required in Nebraska?
Medicare Part D is not a requirement in Nebraska or any other state - no part of Medicare is. However, not signing up for Part D if you do not already have creditable drug coverage (coverage equal to Medicare), you risk lifelong late fees. Part D late penalties accrue any time you go 63 days or more without drug coverage.
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