If you are ready to enroll in Medicare, then it is time for you to learn about Medicare Part D. While Original Medicare (Parts A and B) provide hospital and medical insurance, neither covers prescription drugs.
What is Medicare Part D in Virginia?
Medicare Part D allows Virginians to obtain prescription drug coverage through Medicare. There are two ways to get it:
- Sign up for a standalone Part D plan in addition to Original Medicare
- Sign up for a Medicare Advantage Prescription Drug (MA-PD) plan
If you choose to sign up for drug coverage through a Medicare Advantage plan, you need to make sure it is an MA-PD plan to get drug coverage. Both methods are provided by private insurance companies that contract with Medicare in Virginia.
Medicare Part D requirements in Virginia
If you are signed up for either Part of Original Medicare, you are eligible for Medicare Part D. The plan you choose may have its own requirements to be met, but usually you just need to live in the service area.
When can you sign up for Medicare Part D in Virginia?
Medicare enrollment is limited to specific times:
- Initial Enrollment Period (IEP): This period begins three months before the month you turn 65 and lasts for the three months following. Once you've signed up for Original Medicare, you can enroll in a Part D plan.
- General Enrollment Period (GEP): From January 1 through March 31, you cannot sign up for a Part D plan during the GEP. However, you can enroll in Part D from April 1 to June 30.
- Medicare Annual Enrollment Period (AEP): Starting October 15 and lasting through December 7, current Medicare enrollees can sign up for Part D during the AEP.
- Medicare Advantage Open Enrollment Period (OEP): If you currently have Medicare Advantage, between January 1 and March 31 you can switch between MA plans or go back to Original Medicare. You may also sign up for Part D if you lose drug coverage during this time.
Should you miss any of these enrollment times, you would need to qualify for a Special Enrollment Period (SEP) to sign up. For a full list of special circumstances, check here.
Comparing Medicare Part D plans in Virginia
Your options for Part D plans in Virginia depend on the company you choose and the service area you live in. Primarily, you want to look at coverage and costs.
Be sure to check the formulary for any plan that interests you. A formulary is a tiered list of the prescriptions a plan covers, with lower-tiered medications being cheaper. You want to make sure the formulary has your medications, but also that they aren't places in too high a tier.
Don't forget to compare the costs of a plan's medications to its annual deductible and monthly premiums. You want to make sure that all three out-of-pocket costs don't add up beyond your budget.
If you do find yourself with limited resources, see if you qualify for Extra Help, a program made to help cover Part D costs.
Is Medicare Part D mandatory in Virginia?
No aspect of Medicare is mandatory in any state, but that does not mean you shouldn't sign up for Part D as soon as possible. If you do not have creditable drug coverage elsewhere, such as an employer, you risk building up lifelong late fees.
Any time you go at least 63 days without creditable drug coverage, you begin accruing late penalties that must be paid for the entire time you have Medicare Part D.
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