Medicare.gov - Tutorial - Plan Cost Estimation without Entering Drug Information
Back at the screen where you chose to enter your drug information (Plan Finder Step 2 of 4), you also had two opportunities to go directly to the Medicare plans and skip the drug entry process.
You could have chosen either: "I don’t want to add drugs now" or "I don’t take any drugs".
Both options in Plan Finder Step 2 of 4 skip the drug entry page and bring you directly to this Step 4 of 4. However, the two similar options lead to different results with the "I don’t want to add drugs now" option adding in an estimated value of your medication costs even though no drugs were added.
Option 1: "I don’t want to add drugs now".
If you chose not to enter any prescription drugs in the Plan Finder Step 2 of 4 ("I don’t want to add drugs now") , the Plan Finder still estimates your prescription drug cost for someone in "Good" health would be a certain value per year (and this estimated value changes each year). (Please note that the Medicare.gov Plan Finder default health value is always "Good", but you can change this value if you feel your health can better be described as Poor or Excellent. ) In July of 2013, the estimated annual drug cost was $3,636 for a person with "Good" health.
Your default or chosen health status can be changed on the previous screen of Step 4 of 4 and does not need to remain Good. When we changed the Health Status on the previous screen (left hand side, bottom of the options) to "Poor", our new estimated annual retail drug cost without having chosen any prescription drug coverage increased to $7,296. If we go back and change the Health Status to "Excellent", our annual retail drug cost estimate would then change to $1,656.
Since there is no better Health Status choice than "Excellent", people who take no prescriptions can either just ignore the annual Medicare drug cost estimate at this point or go back to Step 2 of 4 and click on "I don’t take any drugs" to get a better idea of having a Medicare Part D plan, not using any prescription medications, and only paying the monthly Medicare plan premiums.
Remember, with this option of "I don’t want to add drugs now", the Medicare.gov cost figure is simply an estimation of your costs. Your actual annual Medicare prescription drug costs can deviate significantly from this estimate.
If you chose "I don’t take any drugs" back in Step 2 of 4 "Enter Your Drugs", you will see the only annual cost for a Medicare Part D prescription drug plans is simply the cost of the monthly premiums and no estimated drug cost is added.
Therefore, if you just want the lowest costing Medicare prescription drug plan so you can avoid any late—enrollment premium penalty or just to have some form of prescription drug insurance, you can use this Option 2 to quickly see the lowest annual costing plan available in your area by choosing "I don’t take any drugs" back in Plan Finder Step 2 of 4.
Remember that if your health status changes before you enroll in a Medicare plan, you can always go back to Step 2 of 4 and enter any medications that you need covered.
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
Beneficiaries can appoint a representative by submitting CMS Form-1696.