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How to Find Out if You Have Medicare Part D

Medicare written on desk with stethoscope and pills
Just the essentials...
  • Medicare Part D is the prescription drug benefit of national health program for older Americans
  • Medicare Part D consists of private insurance plans reviewed and approved for sale by the CMS
  • Medicare Part D works with Original Medicare or Medicare Advantage
  • Medicare Part D does not work with MA-PD Medicare Advantage with Prescription Drug benefits
  • The CMS reviews formularies and price tier structures for each Part D plan

Getting Medicare Part D is an excellent step towards health security. The costs if prescription drugs can run into many thousands for intensive usages such as surgeries, transplants, and long-term maintenance of certain conditions like heart disease.

Medicare Part D requires an act on the part of the applicant or someone on their behalf. There is no automatic signup for Part D. One can get the benefits of Part D in an all-in-one type policy under Part C: Medicare Advantage.

Enter your zip code above to find the right prescription drug coverage and health insurance plan for you!

Medicare Checks Enrollment

medicare enrollment form

You can reach Medicare online, by phone, by mail, or in-person at your local Social Security or Medicare offices. Online enrollment check offers fast answers and 24-hour access to information.

Medicare approves Part D plans, and the plans utilize the Medicare ID to establish eligibility. The connection of the records makes for a convenient system check of status.

Getting Prescriptions with Part D ID

Each enrolled beneficiary has a Medicare ID card. Each beneficiary gets a prescription drug plan ID card. They also get a number that identifies them to the pharmacists and doctors that provide medications.

The Prescription plan uses the Medicare ID number in record keeping; by checking the Medicare ID number the Part D plan will show on system records. Beneficiaries can often use the Part D benefits before they receive a member card by using their Medicare ID.

Medicare Has Four Parts

Types of Medicare chart

Medicare has four parts and a supplement. Medigap supplemental coverage is the additional component that ties Original Medicare financing together by covering the gaps in Parts A and B. The below-itemized descriptions cover the essential parts of Medicare.

  • Part A: Hospital Insurance is the main part of Original Medicare. It meets the requirements for qualified health coverage under the Affordable Care Act. This is hospital insurance and all of the equipment and facilities needed to diagnose and treat disease in an inpatient setting.
  • Part B: Medical Insurance is medical insurance focused on outpatient based treatment using drugs and durable medical equipment, prosthetics, orthotics, and related supplies. Parts A and B combined make up the Original Medicare.
  • Part C: Medicare Advantage is the collection of private plans that provide the coverage and Original Medicare but with variations that add consumer options. Some offer lower costs than Original Medicare and prescription drug benefits as an all-in-one combination.
  • Part D: Prescription Drug Benefits is the protection for older Americans who must depend on medications as part of the management of medical conditions. Part D covers outpatient drug prescriptions, and it provides substantial savings for users. Part D consists of private plans approved by the CMS for sale to Medicare Beneficiaries. Part D plans work with original Medicare to cover the primary sources of medical costs, drugs, inpatient care and outpatient medical services.
  • Medicare Supplement is not a major part of Medicare protection, rather it is gap insurance that makes the other parts of Original Medicare work better. Medicare Supplement, also known as Medigap, pays the coinsurance balances left by Part B and Part A benefits.

Complex Medication Issues

Packets of prescription drugs

Managing medications can be a tedious and demanding task. Sometimes the person least able to do it is the patient. Medicare offers some assistance in the task of organizing medications, and guarding against interactions and side effects.

The Medication Therapy Management program can help Medicare users make sense of prescription drugs and protect against unwanted outcomes.

It helps in small but important ways like when using over the counter medications while on prescription drugs. It is a free program that connects patients to pharmacy experts that analyze the usage and make records and recommendations.

Tiers and Restrictions

regulations folder on keyboard

Drug plans have lists of covered drugs and arrangements called tiers that rate them by their price. Plans can set rules to limit access to certain high priced drugs and require participants to consider lower cost alternatives or equally effective generics. The CMS plays close attention to formularies and requires that the plan provider update them and keep them current.

Stand-alone Part D Plans

Medicare users in Original Medicare or Medicare Advantage can get Part D coverage. Part D prescription plans are stand-alone plans. They did not need to be part of a larger plan such as a Medicare Advantage health plan.

Stand-alone plans work well with Original Medicare. One might consider the combination of Medicare A, Medicare Part B, and a Medicare Part D plan as a complete package of health care protection.

Dual Eligible Beneficiaries and Part D

Dual eligible persons get various levels of assistance from Medicaid for Medicare costs. This includes prescription benefits where Medicaid provides Part D plan benefits with subsidized premiums and copays.

Medicare Part D is an Important Healthcare Asset

Stethoscope and heart

Both for inpatient and outpatient settings, doctors use powerful pharmaceuticals. Prescription drugs are a vital part of the American healthcare system. Medicare Part D protects older Americans against the high costs of prescription medicines. Part D makes drug-based treatment feasible for millions of Americans.

The discounts and subsidies keep valued medicines within the budgets of those that depend on them for treatment. It works with nearly every other type of insurance to provide price protection for beneficiaries.

How to Confirm Part D

Senior woman with younger woman

The Centers for Medicare and Medicaid provides proof of enrollment in each part of Medicare. Medicare can provide Evidence of Coverage information to applicants by mail requests, online, or by telephone. Beneficiaries can get Part D as a stand-alone plan or as Part of Medicare Advantage.

The standard Medicare ID card indicates the benefits. The card will state that the beneficiary has enrolled in Parts A, B. or C. The private insurance plans in Part D issue ID cards that state the terms of membership. Medicare records can locate approved Part D membership.

Enrolling in Part D

The best time to enroll in a Drug Plan is the initial enrollment period around the 65th birthday. For most people, this is the first chance to get Medicare. Getting and keeping Part D coverage is important for health and financial security. Once one misses the chance to enroll in the Initial Enrollment Period, one can look for the below-listed opportunities to enroll.

  • General enrollment runs from January 1 through March 31
  • Open enrollment runs from October 15 through December 7
  • Special enrollment periods that run for up to eight months after a qualifying event such as losing coverage by losing a job.

Checking Part D Is Easy and Simple

An elderly couple reading a newspaper

One can go online to Medicare.gov to check eligibility and status in any part of Medicare. Beneficiaries must choose whether to have a combination plan or a stand-alone drug plan. Comparison shopping is an ideal method for finding the best features and meeting the consumer’s priorities.

The private plans in Medicare Parts C, D, and Medicare Supplement requires focused analysis to get the best match. Comparison shopping helps the consumer focus on the parts of the plans that are most important to them.

Find your perfect Medicare coverage by entering your zip code below; our search tool is fast, free and easy-to-use!

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MedicareInsurance.com is privately owned and operated. MedicareInsurance.com is a non-government asset for people on Medicare, providing resources in easy to understand format. The government Medicare site is www.medicare.gov.

This website and its contents are for informational purposes only and should not be a substitute for experienced medical advice. We recommend consulting with your medical provider regarding diagnosis or treatment, including choices about changes to medication, treatments, diets, daily routines, or exercise.

This communication’s purpose is insurance solicitation. A licensed insurance agent/producer or insurance company will contact you. Medicare Supplement insurance plans are not linked with or sanctioned by the U.S. government or the federal Medicare program.

MULTIPLAN_GHHK5LLEN_Accepted Last Updated 3/18/2018