If you are planning on enrolling in Medicare, whether Parts A and B (Original Medicare) or through Medicare Advantage (Medicare Part C), you need to understand Medicare Part D.
What is Medicare Part D in South Carolina?
Medicare Part D is Medicare's prescription drug coverage, and helps residents of South Carolina cover the cost of medications. There are two ways to get drug coverage through Medicare:
- Sign up for a standalone Medicare Part D plan
- Sign up for a Medicare Advantage Prescription Drug (MA-PD) plan
Remember, though Part C plans usually have drug coverage, it needs to be designated an MA-PD plan to indicate coverage. Both options are offered by private insurance companies contracted with Medicare in South Carolina.
Medicare Part D requirements in South Carolina
As long as you are eligible for Medicare and signed up for Part A and/or Part B, you are eligible for Medicare Part D. You may need to meet plan-specific requirements, but that is usually just that you live in the service area.
When can you sign up for Medicare Part D in South Carolina?
There are a few times you can enroll in Medicare:
- Initial Enrollment Period (IEP): Your IEP starts three months before you turn 65 and lasts for three months after, for a period totalling seven months. Once you have signed up for one of the Parts of Original Medicare, you can enroll in Part D.
- General Enrollment Period (GEP): Though you cannot sign up for Medicare Part D during the GEP (January 1 through March 31), you can enroll in a Part D plan immediately afterward from April 1 through June 30.
- Annual Enrollment Period (AEP): Between October 15 and December 7 every year, current Medicare enrollees may sign up for Medicare Part D.
- Medicare Advantage Open Enrollment Period (OEP): Medicare Advantage enrollees can use this time to make coverage changes or switch to Original Medicare. If these changes cause you to lose drug coverage, you can sign up for Part D. The OEP lasts from January 1 through March 31.
You may qualify for a Special Enrollment Period (SEP) that allows you to sign up outside of these specific periods. For a list of special circumstances, check here.
Comparing Medicare Part D plans in South Carolina
Medicare Part D plans vary in cost and coverage based on the provider you choose, so comparing plans is all about making sure your needs are met within your budget.
You need to study each prospective plan's formulary, which is a tiered list of the prescriptions a plan will cover. Medications in higher tiers cost more, so be sure to check multiple plans to make sure you get the best price. Weigh the cost of copays with the plan's annual deductible and monthly premium. You don't want low-cost medication at the expense of sky-high premiums.
If resources are limited, see if you qualify for Extra Help. This program is designed to help pay Part D costs.
What happens if you don't sign up for Medicare Part D in South Carolina ?
While Medicare Part D is not required of anyone in South Carolina, or any other state, it is still a good idea to sign up as soon as you are eligible. If you do not have Medicare Part D or creditable coverage elsewhere (coverage considered equivalent to Medicare in price and scope of coverage) you risk lifelong late fees.
Any time you go 63 days or more without drug coverage, you accrue late penalties. You pay these fees for as long as you have Medicare Part D.
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