I disagree with the penalty, what can I do?

If you don’t agree with your penalty, you may ask that your case be reviewed or reconsidered. Once you submit your request, your Medicare drug plan will mail you a reconsideration request form with a deadline listed on it. You must complete that form and return it to you plan by the date listed therein. You will need proof that supports your claim. For example, if you had other creditable coverage, you must provide information about that coverage


Which drugs are covered?

Each plan covers a variety of drugs including generics, brand name, and specialty drugs.  These drugs are listed in a list, or book called a formulary. Medicare drug plans categorize drugs into d “tiers” on their formularies.  The tier in which your drug falls will determine its cost.  Generally, lower tier drugs cost less than higher tier drugs. Most plans have four or five tiers. So, a tier 1 drug, will cost less than a tier 3 drug. Your doctor will, generally, prescribe you tier 1 drugs to keep your cost low. However, not all drugs are available as a tier 1 drug. In those cases, your doctor will prescribe you a higher tier drug, which will have a higher cost.


Can I get automatic prescription refills in the mail?

Yes. Most plans offer prescription refills via mail order. Prescriptions may be refilled automatically and delivered when they’re about to run out. Your plan should contact you before “automatically” shipping a refill; this is to make sure that you are still in need of that refill. If you receive an automatic refill that you no longer need, and the plan failed to contact you prior to shipping it, you may send it back and request a refund.


Do other insurance programs work in conjunction with Part D?

Yes. It works with employer or union health coverage, COBRA, and Medigap policies.


Is there other government insurance that works with Part D?

Yes. Other government insurance that works with Part D include the Federal Employee Health Benefits (FEBH) program, Veterans’ benefits, TRICARE, and Indian Health Service (IHS).

Frequently Asked Questions (FAQs)