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Medicare Part D Blog

Browse the Most Viewed and Newest Medicare Part D Blogs
Any thoughts?  If you wish to add your comments, please submit your comments to us through our Online Help Desk.

Most Viewed Blogs


WellCare Medicare Plan 2014 & 2015 Pharmacy and Provider Search Tools
The WellCare stand-alone Medicare Part D (PDP) plan pharmacy search tool is available at: https://www.wellcarepdp.com/our_pharmacies/default. The WellCare Medicare Advantage plan pharmacy, service ...

2015 Federal Poverty Level Guidelines: 2015-2016 LIS Qualifications and Benefits
The 2015 Federal Poverty Level (FPL) Guidelines determine the income level requirements for people applying for the Medicare Part D Low Income Subsidy (LIS) program, also known as the "Extra Help" pro ...

Medicare Advantage plan and Medicare Part D prescription drug plan Special Enrollment Periods(SEP)
In certain situations, people with Medicare may be eligible for a Special Enrollment Period (SEP) allowing them to join a Medicare Advantage plan or Medicare Part D prescription drug plan , or switch ...

2015 Low-Income Subsidy Benchmark Premium Amounts (includes 2015 - 2006 for comparison)
The Centers for Medicare and Medicaid Services (CMS) released the 2015 low-income premium subsidy amounts (or Benchmark) for Medicare Part D plans on July 31, 2014. The benchmark is the maximum m ...

Does Medicare Cover Vitamin B-12 Injections (Shots)?
In specific cases, Medicare will cover Vitamin B-12 injections.  Please read the excerpt below from Medicare Benefit Policy Manual, Chapter 7 - Home Health Services. Intravenous, intramuscular, ...

Medicaid "Spend Down" and Medicare Part D
People with Medicare who are also eligible for Medicaid because of high medical expenses can get Medicare prescription drug coverage no matter if they are in the Original Medicare Plan or a Medicare A ...

Slightly higher Income Related Medicare Adjustment Amounts (IRMAA) in 2015 for Medicare beneficiaries with higher annual incomes.
Medicare Part D beneficiaries with an income above a certain level (see charts below) have an increase in their monthly Medicare Part D prescription drug plan premiums, based on the implementation of ...

The Medicare & You Handbook is online and available for download
If you are a Medicare beneficiary, you should have received a printed version of the Medicare & You Handbook prepared by the Centers for Medicare and Medicaid Services (CMS or Medicare) som ...

How do you choose a new Medicare Part D plan?
I am trying to select a new Medicare Part D Plan and I need help!  How do you choose a Medicare Part D plan for 2007? This question is being asked by almost everyone who is faced, either for the ...

Fifty-Four (54) New Generic Equivalents Added to Medicare Part D in May 2014
The most recent (May 2014) Medicare Part D plan formulary data (or drug lists) updates include the addition of 285 new National Drug Codes  (NDC) to the Medicare Part D program.  These repre ...

Newest Blogs


First Health & Coventry Health 2015 Medicare Part D Healthcare Provider and Pharmacy Search Tools
Healthcare ProvidersThe 2015 Coventry Health Medicare Advantage plan provider search (doctors, hospitals & dentists) tool can also be found on the Coventry website at http://coventry-medicare.cov ...

2015 Federal Poverty Level Guidelines: 2015-2016 LIS Qualifications and Benefits
The 2015 Federal Poverty Level (FPL) Guidelines determine the income level requirements for people applying for the Medicare Part D Low Income Subsidy (LIS) program, also known as the "Extra Help" pro ...

Hackers breach Anthem's database system accessing information for past and current health plan members
Anthem, Inc. learned last week that hackers had gained unauthorized access to Anthem's data systems and obtained personal information from current and former health plan members -- and Anthem employee ...

Why you may be paying more in 2015: Changes in 2015 prescription co-payments or cost-sharing designs
As in past years, some 2014 Medicare Part D plans are changing their cost-sharing rates for 2015 prescription drug purchases.  For example, the EnvisionRxPlus Silver plan will remove the Non-Pr ...

Drug Tiers: How drugs are organized on the 2015 Medicare Part D plan formularies
Medicare prescription drug plans organize covered medications into different logical categories or tiers -- each with a different co-payment or cost-sharing amount (for instance, you may have a $5 co- ...

Why you may be paying more in 2015: Your Medicare Part D prescription drug plan now has a deductible.
The following chart shows a few examples of 2015 Medicare Part D plans with increases to their initial deductible.  As can be seen, members of the WellCare Classic plan, the First Health Part D V ...

2015 Donut Hole discount example for a $250 brand name medication purchase
Question:  I use a brand name drug that usually costs $250 and has no generic. What will I pay for this medication once I reach the Donut Hole or the Catastrophic Coverage portion of my 2015 ...

2015 Medicare Part D and Medicare Advantage Plans with Consistently Low CMS Quality Ratings
The chart below lists the 2015 Medicare Advantage plans that have received low quality ratings for the last three years, and therefore members may qualify for a Special Enrollment Period (SEP) to ...

2015 Medicare Part D and Medicare Advantage Plans with a CMS 5-Star Quality Rating
The chart below lists the Medicare Part D and Medicare Advantage plans that have a 5-Star CMS quality rating for the plan year 2015.  Click on the Plan ID to see plan details including servi ...

Dropping your Medicare Advantage plan during the Medicare Advantage Disenrollment Period (MADP)
Question:  I joined a Medicare Advantage plan that has prescription drug coverage, but now I am not sure I want to keep this plan.  Is there any way to just drop my Medicare Advantage plan?Y ...




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Tips & Disclaimers
  • The Medicare Advantage and Medicare Part D prescription drug plan data on our site comes directly from Medicare and is subject to change.
  • Medicare has neither reviewed nor endorsed the information on our site.
  • We provide our Q1Medicare.com site for educational purposes and strive to present unbiased and accurate information. However, Q1Medicare is not intended as a substitute for your lawyer, doctor, healthcare provider, financial advisor, or pharmacist. For more information on your Medicare coverage, please be sure to seek legal, medical, pharmaceutical, or financial advice from a licensed professional or telephone Medicare at 1-800-633-4227.
  • Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. Our PDP-Compare.com and MA-Compare.com provide highlights of annual plan benefit changes.
  • The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan.
  • Limitations, copayments, and restrictions may apply.
  • We make every effort to show all available Medicare Part D or Medicare Advantage plans in your service area. However, since our data is provided by Medicare, it is possible that this may not be a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.
  • When enrolling in a Medicare Advantage plan, you must continue to pay your Medicare Part B premium.
  • Medicare beneficiaries with higher incomes may be required to pay both a Medicare Part B and Medicare Part D Income Related Monthly Adjustment Amount (IRMAA). Read more on IRMAA.
  • Medicare Advantage plans that include prescription drug coverage (MAPDs) are considered Medicare Part D plans and members with higher incomes may be subject to the Medicare Part D Income Related Monthly Adjustment Amount (IRMAA), just as members in stand-alone Part D plans. In certain situations, you can appeal IRMAA.
  • You must be enrolled in both Medicare Part A and Part B to enroll in a Medicare Advantage plan. Members may enroll in a Medicare Advantage plan only during specific times of the year. Contact the Medicare plan for more information.
  • If you are enrolled in a Medicare plan with Part D prescription drug coverage, you may be eligible for financial Extra Help to assist with the payment of your prescription drug premiums and drug purchases. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or your state Medicaid Office.
  • Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next.
  • A Medicare Advantage Private Fee-for-Service plan (PFFS) is not a Medicare supplement plan. Providers who do not contract with the plan are not required to see you except in an emergency.
  • Disclaimer for Institutional Special Needs Plan (SNP): This plan is available to anyone with Medicare who meets the Skilled Nursing Facility (SNF) level of care and resides in a nursing home.
  • Disclaimer for Dual Eligible (Medicare/Medicaid) Special Needs Plan (SNP): This plan is available to anyone who has both Medical Assistance from the State and Medicare. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.
  • Disclaimer for Chronic Condition Special Needs Plan (SNP): This plan is available to anyone with Medicare who has been diagnosed with the plan specific Chronic Condition.
  • Medicare MSA Plans combine a high deductible Medicare Advantage Plan and a trust or custodial savings account (as defined and/or approved by the IRS). The plan deposits money from Medicare into the account. You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins.
  • Medicare MSA Plans do not cover prescription drugs. If you join a Medicare MSA Plan, you can also join any separate (stand-alone) Medicare Part D prescription drug plan
  • There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. Those who disenroll during the calendar year will owe a portion of the account deposit back to the plan. Contact the plan provider for additional information.
  • Medicare beneficiaries may enroll through the CMS Medicare Online Enrollment Center located at www.medicare.gov.
  • Medicare beneficiaries can file a complaint with the Centers for Medicare & Medicaid Services by calling 1-800-MEDICARE 24 hours a day/7 days or using the medicare.gov site. Beneficiaries can appoint a representative by submitting CMS Form-1696.


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