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Questions & Answers (FAQ)

Browse the Most Viewed and Newest Medicare Part D FAQs
If you still have questions, please contact us through our Online Help Desk.

Most Viewed FAQs


I wish to cancel my Medicare Part D prescription drug plan coverage. What should I do?
In most cases, you can only disenroll or cancel your Medicare Part D plan or Medicare Advantage plan during the Annual Enrollment Period (AEP) or annual Open Enrollment Period (OEP) which runs from ...

What is the BIN, PCN, and GROUP for my WellCare Medicare Part D prescription drug plan?
You can use your prescription drug plan even without having your Member ID card.  There are four numbers that your pharmacist needs to use your WellCare Medicare Part D prescription drug plan -...

Where can I get a Medical Power of Attorney form?
You can download a free Medical Power of Attorney form in our blog:Click here to go to our blog: Notes on Medical Power of Attorney. (http://www.q1medicare.com/q1group/Blog.php?blog_id=92)...

What is a Specified Low - Income Medicare Beneficiary (or SLMB)?
If you are eligible for Medicare (whether you are just turning 65 or are Medicare eligible because of a disability) and you have limited financial resources and income, you may be able to receive some...

I am considering changing my prescription drug coverage to the Humana Walmart-Preferred Rx Plan and I was wondering if I can only go to Walmart for my prescriptions?
  No, you do not have to use Walmart as your only pharmacy.  The Humana Medicare Part D plans include over 50,000+ pharmacies in their network. However, you may pay much more for your ...

Does Medicare Part D pay for the shingles vaccine?
Zostavax was approved in May 2006 by the U.S. Food and Drug Administration (FDA) as a vaccine for use in adults ages 60 and over who have had chickenpox.  Zostavax is covered under most Medicare ...

How do I get a prior authorization form for Humana?
Humana has now moved to an online form for prior authorization. Here is a link to the Humana online prior authorization form: https://humana.promptpa.com/ ...

Where can I download a copy of the Humana Formulary
You can browse any Medicare Part D (PDP) or Medicare Advantage (MAPD) plan formulary online at FormularyBrowser.com We no longer offer formularies in PDF format for download.....

What kind of discount can we expect in the Doughnut Hole?
Starting back in the 2011 Medicare Part D plan year, a discount or co-insurance (cost-sharing) was introduced to reduce the cost of generic and brand-name prescription drugs purchased by non-LIS ...

How do I contact Humana about my Medicare Part D plan?
You can telephone Humana New Member Services at:1-888-839-7316 or Humana Customer Service at:1-800-457-4708.orHumana Enrollment & Information Center at: 1-800-833-6578or Humana Billing Depart...

Newest FAQs


Why do some websites have disclaimers when Medicare Part D or Medicare Advantage plan benefits are mentioned?
The CMS Medicare Marketing Guidelines require that websites marketing Medicare Part D and/or Medicare Advantage plans include certain disclaimers.Section 50.2 of the Medicare Marketing Guidelines, ent...

How do I get a prior authorization form for Humana?
Humana has now moved to an online form for prior authorization. Here is a link to the Humana online prior authorization form: https://humana.promptpa.com/ ...

What does the letter or letters mean that comes after my Medicare claim number?
Take a look at your red, white, and blue Medicare card.  We often hear from people asking what the letter or letters mean in their Medicare claim number (for instance "123-45-6789 T").  Bel...

Special Enrollment Period (SEP) to Leave a Consistently Low Rated Medicare Part D or Medicare Advantage Plan
To promote high Medicare Part D and Medicare Advantage plan quality, The Centers for Medicare and Medicaid Services (CMS) will alert plan members if their Medicare Part D drug plan or Medicare Adv...

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?
Yes. You can drop your Medicare Advantage Plan during the annual Medicare Advantage plan Disenrollment Period (or MADP) that runs from January 1st until February 14th of each year. Please rememb...

Does the Donut Hole or Coverage Gap restart every year on January 1st or do we stay in the Coverage Gap from the previous year?
Yes, your Medicare Part D plan coverage, including your Donut Hole (or Doughnut Hole) or Coverage Gap begins again at the start of each new year. For example, if you were in the 2014 Coverage Gap, ...

If I decide not to join any Medicare prescription drug plan and I don’t have any other prescription coverage, how long will I have to pay the late-enrollment premium penalty?
Probably forever.  The late-enrollment premium penalty is permanent for most people over 65 and you will pay the penalty as long as you have a Medicare Part D prescription drug plan. However, ...

What is a Workers Compensation Medicare Set Aside Arrangement (WCMSA)?
A Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) is a financial agreement that allocates a portion of a workers’ compensation settlement to pay for future medical services ...

Does my Medicare Part D plan or Medicare Advantage plan also provide Silver Sneakers coverage?
Your stand-alone Medicare Part D prescription drug plan (PDP) only provides coverage for your prescription medications and probably does not include a fitness benefit.However, many Medicare Advantage ...

When a Non-Renewing Medicare Part D or Medicare Advantage plan reassigns members to another plan does the SEP through February apply?
No.  The Special Enrollment Period through end of February for Service Area Reduction or Medicare plan cancellation Special Enrollment Period (SAR SEP) would NOT apply....




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: : PDP-Facts: 2015 Medicare Part D plan Facts & Figures
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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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