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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 ...

2016 Low-Income Subsidy Benchmark Premium Amounts (includes 2016 - 2006 for comparison)
The Centers for Medicare and Medicaid Services (CMS) released the 2016 low-income premium subsidy amounts (or Benchmark) for Medicare Part D plans on July 29, 2015.  In 2016, eleven (11) states ...

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 ...

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.  Section 40.1.2.4 -Administrati ...

What does the letter after my Medicare number mean?
We have been getting more questions from people asking what the letters mean in their Medicare Claim Number.  Here is an explanation and chart of the letter meaning provided by the Social Securit ...

Roughly a 3% increase in the 2016 Income Related Medicare Adjustment Amounts (IRMAA) 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 ...

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 ...

WellCare Medicare Plan 2015 & 2016 Medicare Pharmacy and Healthcare Provider Search Tools
You can find the 2016 WellCare Medicare Part D (PDP) pharmacy search and Medicare Advantage plan provider search tool at:  https://www.wellcare.com/Find-a-Provider#/Search. You can also start at: ...

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 ...

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 ...

. Latest News


Why you may be paying more for your medications in 2016: Changes in 2016 prescription co-payments or cost-sharing designs
Your Medicare Part D plan's cost-sharing structure (how the plan's formulary is divided into drug tiers and the cost-sharing per tier) directly influences your medication costs.  When a new drug ...

Why you may be paying more for your medications in 2016: Your Medicare Part D prescription drug plan has a deductible change.
Your Medicare Part D plan's Initial Deductible affects your prescription drug costs in that you are responsible for 100% of your drug costs until you meet your plan's Initial Deductible.  After y ...

Why you may be paying more for your medications in 2016: Increases in your 2016 prescription co-payments or cost-sharing
Very few Medicare Part D plans keep their cost-sharing (co-payments and/or co-insurance) the same from year to year.  Rather, your portion of your prescription costs has a tendency to rise.  ...

CMS Imposition of Immediate Sanctions on Cigna-HealthSpring: Suspension of Enrollment and Marketing for Cigna-HealthSpring MAPDs and PDPs.
On January 21, 2016, the Centers for Medicare and Medicaid Services (CMS) imposed immediate intermediate sanctions (suspension of enrollment and marketing) for the Cigna-HealthSpring Medicare Advantag ...

What is the 2016 Initial Coverage Limit and how does the ICL work?
The 2016 standard Initial Coverage Limit (ICL) is $3,310. The Initial Coverage Limit is the measured by the retail cost of your drug purchases and is used to determine when you leave your Medicare ...

I am qualified for Medicaid and receive full Medicare Part D Extra Help, so why is my drug plan charging me an $11 monthly premium?
Your chosen Medicare Part D prescription drug plan exceeds your state's Medicare Part D $0 benchmark premium.If you are qualified for full Extra Help or the Medicare Part D Low-Income Subsidy (LIS), t ...

What to do if you are still waiting for your 2016 Medicare Part D prescription drug plan Member ID card.
If you still have not received your new 2016 Medicare Part D or Medicare Advantage plan Member ID card, please contact your Medicare plan’s Member Services department - confirm your enrollment, ...

October 2015 Summary of the new Medications added to Medicare Part D Plan Formularies (Drug Lists) for January 2016
The 2016 Medicare Part D plan formulary data (or drug lists) released in October 2015 include the addition of 167 new National Drug Codes (NDC) to the Medicare Part D program.  These NDCs represe ...

Reminder: the 2016 annual Open Enrollment Period (AEP) ends tonight, December 7th at midnight.
During these last few hours of the 2016 Fall Open Enrollment Period (or AEP), you can join, change, or drop your Medicare Part D or Medicare Advantage plan coverage.   You can also still choose ...

You still have time to choose a 2016 Medicare Part D or Medicare Advantage plan.
The 2016 annual Fall Open Enrollment Period (or AEP) continues through midnight of Monday, December 7th. During the Open Enrollment Period, you can join, change, or drop your Medicare Part D or ...




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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.
  • We are an independent education, research, and technology company. We are not affiliated with any Medicare plan, plan carrier, healthcare provider, or insurance company. We are not compensated for Medicare plan enrollments. We do not sell leads or share your personal information.
  • 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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