Ready to sign up for Medicare? Then it is important you learn about Medicare Part D. Though many know to sign up for Medicare Part A and Part B (also known as Original Medicare), not everyone realizes that you need a Part D plan for prescription drug coverage.
What is Medicare Part D in Oregon?
Medicare Part D is how Oregonians get their prescription drug coverage through Medicare. You can either sign up for a standalone Part D plan, or for a Medicare Advantage Prescription Drug (MA-PD) plan. If you choose an MA-PD plan, your Parts A, B, and D will be on a single policy.
Regardless of the option you choose, all Part D plans are offered by private insurance companies that contract with Medicare in Oregon.
Medicare Part D requirements in Oregon
There are only two requirements for enrolling in Medicare Part D in Oregon:
- Be eligible for Medicare and enrolled in Parts A and/or B
- Meet any plan-specific requirements (usually only that you be in the service area)
As long as you meet these requirements, you can sign up for Medicare Part D.
When can you sign up for Medicare Part D in Oregon?
Medicare enrollment is limited to specific times throughout the year.
- Initial Enrollment Period (IEP): The only period that does not come up again every year, your IEP starts three months before the month of your 65th birthday and lasts for the following three. This is the first time you can enroll in any Medicare program.
- General Enrollment Period (GEP): If you miss your IEP, you can sign up for Original Medicare from January 1 through March 31. Immediately following, from April 1 through June 30, you can sign up for Medicare Part D.
- Annual Enrollment Period (AEP): From October 15 to December 7 every year, current Medicare beneficiaries can make changes to their coverage and sign up for Part D.
- Medicare Advantage Open Enrollment Period (OEP): From January 1 through March 31, Medicare Advantage enrollees may make changes to their coverage or switch to Original Medicare. If you lose drug coverage due to any changes, you can also sign up for Medicare Part D.
If you miss all of these periods, you would need to qualify for a Special Enrollment Period (SEP).
Comparing Medicare Part D plans in Oregon
Though cost and coverage options vary based on the insurance company you choose, the method of making that choice should be the same.
The first step in picking a plan is reading its drug formulary, which is a tiered list of the medications a plan covers. You want to make sure any prescriptions you need are on the formulary, but pay attention to the tier it falls in, as medications in higher tiers have higher costs.
Also be sure to balance the cost of copays with your deductible and monthly premium. You might be getting savings in one area that are canceled out by other costs.
If resources are limited, it is a good idea to see if you qualify for Medicare's Extra Help, a program that assists with Part D drug costs.
What happens if you don't sign up for Medicare Part D in Oregon?
No part of Medicare is mandatory in Oregon (or any other state), and Part D is no exception. However, if you do not have creditable drug coverage elsewhere (coverage considered equal to medicare in cost and scope) you risk paying late fees.
If you go 63 or more days without drug coverage, you begin accruing these penalties. Late fees are added to your monthly premium for the entire time you have Medicare Part D.
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