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Nebraska State FlagMedicare Part D Plans in Nebraska

Did you know that, according to the Centers for Medicare & Medicaid Services (CMS), the majority of the over 344,000 Nebraskans enrolled in Medicare health coverage also obtained prescription drug coverage through Medicare Part D in 2018? Out of the 344,000 people living in Nebraska with Medicare, over 72 percent got their prescription drug coverage through Medicare Part D. If you don’t know about this important part of Medicare yet, it’s time to learn more.

Learning About Medicare Part D in Nebraska

If you’re one of the millions of Americans who needs prescription medication on a daily basis, you already know that prescriptions costs add up very quickly. In fact, you can spend hundreds or even thousands of dollars every year on the standard prescriptions you need. That’s why it’s so important to learn about Medicare Part D.

If you have prescription drug coverage through Medicare Part D, you could save a significant amount of money, since Part D coverage helps pay for mediations.

To get Part D prescription drug coverage in Nebraska, you have two options:

  • You can purchase a standalone Part D plan to accompany Original Medicare or a Medicare Advantage (MA) plan that doesn't include prescription drug coverage
  • You can choose a Medicare Advantage Prescription Drug plan (MA-PD), which gives you the same coverage as Original Medicare plus a Part D plan

Whether you enroll in a standalone Part D prescription drug plan or you choose to get your coverage through a Medicare Advantage Prescription Drug plan, your coverage is courtesy of private insurance companies that contract with Medicare to provide these benefits.

With a standalone Part D plan, you will have a Part D premium. If you choose a Medicare Advantage Prescription Drug plan, you might not have to pay any Part D premium at all. However, you will probably have to pay a monthly premium for the Advantage plan. And, you always have to continue paying your Medicare Part B premium, even when you sign up for an Advantage plan.

When Can You Get Medicare Part D Coverage in Nebraska?

As soon as you enroll in Medicare Part A and/or Medicare Part B, you are eligible for Medicare Part D. (Medicare Part C is more commonly known as Medicare Advantage.)

When you become eligible for Medicare at age 65, you won't be automatically enrolled in Original Medicare (Part A, hospital insurance, and Part B, medical insurance) unless you began receiving Social Security benefits at least 4 months before your birthday. Everyone else must choose to sign up for Medicare.

People who qualify for Medicare due to a disability are automatically enrolled in Parts A and B on their 25th month of receiving Social Security disability benefits.

Please note that Part D coverage is not included in Original Medicare. You will never be automatically enrolled in Medicare Part D.

Medicare Part D Enrollment Periods in Nebraska

The Medicare program restricts Part D enrollment in Nebraska to specific times.

  • Initial Enrollment Period (IEP): Your IEP lasts for 7 months. It begins 3 months before you become eligible for Medicare and ends 7 months later. If you age-in, your IEP begins 3 months before your 65th birthday. If you qualify based on disability, your IEP opens in your 22nd month of receiving Social Security disability benefits. In both scenarios, if you become eligible for Medicare in June, your IEP opens on March 1 and closes on September 30.
  • General Enrollment Period (GEP): General Enrollment occurs every year from January 1 through March 31. It is available to anyone who did not sign up for Medicare during their IEP. During GEP, you may enroll in Parts A and B, but not in Part D. However, you can sign up for a Part D or MA-PD plan between April 1 and June 30.
  • Medicare Annual Enrollment Period (AEP): Current Medicare beneficiaries may take advantage of AEP to make changes to their coverage. This includes joining a Part D or Medicare Advantage Prescription Drug plan.
  • Medicare Advantage Open Enrollment Period (OEP): This enrollment period is only available to Medicare Advantage beneficiaries. From January 1 through March 31, you may switch to a new Advantage plan or drop your MA plan entirely and return to Original Medicare. The only time you can buy a Part D plan during OEP is if you lose your prescription drug coverage by making one of those changes.

Medicare also offers Special Enrollment Periods (SEPs) to beneficiaries who experience special circumstances, such as moving or losing their current coverage. There are dozens of ways to qualify for an SEP. Find the full list on Medicare.gov here.

Comparing Medicare Part D Coverage in Nebraska

Private insurance companies provide Medicare Part D and Advantage plans, which is why costs and coverage vary according to the plan and provider you choose. To make sure you get the best Part D coverage for your unique needs, you need to compare your plan options carefully.

Although most people focus on cost first, the most important aspect of a Part D plan is its drug formulary. This the list of prescription medications that the plan covers. And if your medications aren't on it, it doesn't matter how cheap the plan is – it won't work for you.

While checking the drug formulary, you should also look at which "tier" your medications are on. Drug tiers indicate how much the medication costs. Medications on the lower tiers cost less than those on the higher tiers.

This leads us directly to cost comparisons. In addition to the monthly premium, your Part D out-of-pocket costs include the yearly deductible and copays or coinsurance. Make sure that a low premium isn't hiding higher out-of-pocket costs elsewhere.

Medicare beneficiaries who have limited income and resources may qualify for Extra Help, a program that helps pay your prescription drug costs. Click here to see if you qualify for Extra Help in Nebraska.

Is Medicare Part D Required in Nebraska?

In a word: No. Nobody has to sign up for Medicare Part D – or any other part of Medicare. Just note that delaying Medicare enrollment when you don't have creditable coverage elsewhere will land you with significant, lifelong late penalties. (Creditable indicates coverage that is equal to Medicare in terms of both cost and coverage.)

You start accruing the Part D late enrollment penalty any time you go 63 days or more without creditable prescription drug coverage.

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