Medicare Part D enrollment period
Medicare plans all have specific periods of time that beneficiaries can use to enroll in each type of plan. Medicare Part D (prescription drug coverage) is no different. There is more than one Medicare Part D enrollment period available to beneficiaries.
Please note: Beneficiaries can get Medicare Part D coverage from either a stand-alone PDP plan or from an MAPD plan.
Why enrolling in Part D is important
If your client asks why they should enroll in Part D coverage, you need to tell them about the late enrollment penalty (LEP). Once a beneficiary incurs a penalty, they have to pay it for as long as they have Medicare Part D coverage. It is added to The Medicare Part D plan premium. This penalty amount is determined by the number of months the beneficiary has gone without creditable drug coverage. The penalty applies after a beneficiary goes 63 days or more without creditable coverage. Creditable coverage means a drug plan that provides coverage at least equal to what Medicare part D provides.
Here are a few instances that can result in an LEP
- When a client Neglects to enroll in Part D as soon as they are eligible. Enrollment in Medicare Part A & Part B is a great indicator of when to enroll in part D coverage. It is important to enroll even if the client is not currently taking any prescription drugs.
- If the beneficiary loses other health coverage such as employer coverage, it is important beneficiaries do not go without creditable coverage for 63 days in a row.
- Once clients are eligible for Medicare, be sure they maintain records of creditable coverage in the event Medicare asks for proof of previous coverage.
The first enrollment period
For most beneficiaries who are aging into Medicare, their IEP for Medicare begins 3 months before the month they are turning 65. Their IEP ends 3 months after they turn 65. During this time, they may decide to enroll in Medicare Part A and Part B. Once they enroll in both Medicare Part A and Part B, they can choose a Part D prescription drug plan.
Annual enrollment periods
Every year during the AEP (Annual Enrollment Period), clients can add, change or drop Part D coverage. This period runs from Oct 15th through Dec 7th. Changes made during this period will go into effect Jan 1 of the following year.
There is also a Medicare Advantage OEP each year, it runs from Jan 1 through March 31st each year. During this enrollment period, beneficiaries can change their Medicare Advantage coverage. The changes include switching from one Medicare advantage plan to another. Thye can also disenroll from a MA/MAPD plan and enroll in Original Medicare as well as a supplement and stand-alone PDP plan (Part D). These changes go into effect the first day following the month they apply.
Special enrollment periods (SEPs)
Ther are other times clients can enroll in a new Part D coverage. These additional opportunities are called special enrollment periods or SEPs. There are many different types of SEPs.
Click here to learn more about SEPs
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How a licensed Medicare agent can help
No matter what election period a beneficiary chooses to use for their Part D enrollment, enlisting the help of a licensed Medicare agent can be a good decision. A Medicare agent can provide guidance to ensure clients choose the best coverage for their individual needs.
There are many plans available, and an accurate comparison can take some of the uncertainty out of choosing a plan. The wrong plan choice can be a very costly mistake, one that is not easily rectified. A good agent will take a list of the client’s medications, the dosage and the pharmacy they like to use. They enter this information into a quote engine that provides clients a comparison of the best plan choices for them.