You’ve reached a point where you’ve got it pretty much all figured out.
You know your Medicare options and are ready to move. Let’s just get this one Part covered.
Medicare Part D is your Medicare prescription drug coverage. Just as Medicare Part A covers your hospital services and Medicare Part B covers your doctor bills, Medicare Part D covers your prescription drugs.
Part D is not included in your Medicare coverage and is entirely voluntary. If you want Part D coverage, you must enroll through a health benefits company like Anthem.
Who Can Get Medicare Drug Coverage?
To join a Medicare Prescription Drug Plan, you must have Medicare Part A and/or Part B. If you would like to get prescription drug coverage through a Medicare Advantage Plan, you must have Part A and Part B. You must also live in the service area of the Medicare drug plan you want to join.
When Can You Join, Switch, or Drop a Medicare Drug Plan?
You can join, switch, or drop a Medicare drug plan at these times:
| When you are first eligible for Medicare (the 7-month period that begins 3 months before the month you turn age 65, includes the month you turn age 65, and ends 3 months after the month you turn age 65). |
| If you get Medicare due to a disability, you can join during the 3 months before to 3 months after your 25th month of disability. You will have another chance to join 3 months before the month you turn age 65 to 3 months after the month you turn age 65. |
| Between November 15 – December 31 each year. Your coverage will begin on January 1 of the following year, as long as the plan gets your enrollment request by December 31. |
| Between January 1 – March 31 of each year if you already have Medicare prescription drug coverage. |
| Anytime, if you qualify for Extra Help or if you have both Medicare and Medicaid. |
In most cases, you must stay enrolled for that calendar year starting the date your coverage begins. However, in certain situations, you may be able to join, switch, or drop Medicare drug plans during a special enrollment period (like if you move out of the service area, lose other creditable prescription drug coverage, or live in an institution).
When choosing a plan, be sure to see if your prescription drugs are covered.
Each plan’s coverage will differ slightly so it’s important to check to see if the drugs you need are covered. Generally Medicare Part D covers drugs available only by prescription, approved by the Food and Drug Administration (FDA) and used and sold in the United States. Part D drugs include prescription drugs, biological products, insulin, vaccines and certain medical supplies associated with the injection of insulin (syringes, needles, alcohol swabs, and gauze). Any drug covered by Medicare Parts A or B will not be covered by Part D.
How much does Anthem’s Medicare Part D plan cost?
Each Anthem plan is slightly different, but you can expect to pay a premium each month. You must also continue to pay your Medicare Part B premium. If you have a limited income, you may be eligible to receive extra help on premiums, deductibles and copayments.
Feel free to use any pharmacy in your substantial network.
You have access to a large network of pharmacies that you’ll be able to use to receive plan benefits. And, network pharmacies will also file your Medicare prescription drug claims for you. If, however, you use a pharmacy that’s not part of your network, your drug prescriptions will not be covered, except in certain cases (examples are a medical emergency or urgent care or when a network pharmacy is unavailable.)
We’ll help you choose a Medicare Part D Plan.
The best way to choose is by comparing the coverage and rates. You can do this by clicking here
for plan details and benefits.
Questions? Need help? Call us at 1-866-693-3339.
We renew our contract with Medicare annually.
The Medicare Contract is renewed annually, and the availability of coverage beyond the end of the current year is not guaranteed. You are eligible to enroll if you are entitled to Medicare Part A and enrolled in Medicare Part B and you live in the service area. You must continue to pay your Medicare Part B premium if not otherwise paid for under Medicaid or by another third party. With some exceptions you can only enroll during certain times of the year.
To obtain an aggregate number of grievances, appeals and exceptions filed or for full information on benefits, please call the Customer Service Department
Please reference the Evidence of Coverage for information on premiums, cost-sharing, out-of-network coverage, rights and responsibilities upon disenrollment and any applicable conditions associated with using the plan benefits. If you have special needs, our Plan documents may be available in other formats. Please call Customer Service
Last Updated 01/24/2011