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Questions & Answers (FAQ)

The categories of Frequently Asked Questions (FAQs) can be found to the right. Simply click on one of the questions below or a category to the right.

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Closing the Coverage Gap
[ All FAQs In This Category ] 
•   What kind of discount can we expect in the Doughnut Hole?
•   For 2011 you indicate that the full retail cost of drugs while in the donut hole will apply to the amount required to get out for name brands even though I'm only paying 50%. Can you clarify?
•   I use a brand name drug, but it is not covered by my Medicare Part D plan. Will the 50% discount on brand-name drugs still apply to this drug when I am in the Donut Hole?
•   I asked my pharmacist about the new discount program and he did not seem to know anything about it. So will I still receive this 50% discount on my refills while I am in the doughnut hole or do I need to find another pharmacy?
•   Does the Donut Hole Discount apply to a retail drug purchase that straddles my Medicare Part D plan's Initial Coverage phase and the Coverage Gap or Donut Hole phase? In other words, does the Donut Hole discount apply to a Straddle Claim?
•   How much do I have to pay for generics in the donut hole in 2011, 2012, 2013,2014, 2015, etc. until it reaches 25%
•   My current prescription drug retail cost are $230 per month. What will be my discount in the Doughnut Hole?
•   Can you provide an example of the 2011 Donut Hole Discount?
•   Will monthly Medicare Part D premiums increase due to the manufacturer’s discount on brand-name drugs purchased in the Coverage Gap?
•   I have a PACE plan, will I get the discount on brand-name drugs purchased in the Coverage Gap?
•   Does everyone receive a discount in the Coverage Gap?
•   Which brand name prescription drugs are eligible for the 2011 Coverage Gap or Donut Hole discount?
•   Will the Coverage Gap discount program affect which brand drugs are offered under Medicare Part D?
•   Who is really paying for the discount on drugs purchased in the Coverage Gap?
•   If I go into the 2011 Coverage Gap, will my Doughnut Hole discount be deducted at the pharmacy or will I get a refund from my Part D plan?
•   Since all 2011 Medicare Part D plans will now have a 7% Coverage Gap discount for generics, will there no longer be plans with a Coverage Gap description of “No Gap Coverage”?
•   I have a Medicare Part D plan that provides coverage for some generics while I am in the Coverage Gap, will this same Doughnut Hole coverage apply to all generics in 2011?
•   Will generic "Bonus Drugs" and generic drugs excluded by Medicare also receive the 7% Coverage Gap discount?
•   Will all Generic drugs get the Coverage Gap discount or only generics drugs in Tier 1 or the lowest formulary tier?
•   Will the Coverage Gap or Donut Hole eventually close?
•   What exactly is TrOOP or True Out of Pocket costs?

The Donut Hole Discount
[ All FAQs In This Category ] 
•   If I reach the 2013 Coverage Gap and get a 52.5% Donut Hole Discount on my brand-name drugs purchases, do I still get full retail credit toward meeting my Donut Hole exit point?
•   I use a brand-name drug, but this medication is not covered by my Medicare Part D plan. Will the 50% discount on brand-name drugs still apply to this drug when I am in the 2012 Donut Hole?
•   If I am already in the Donut Hole, how much money could I possibly save with the 2012 Donut Hole Discount?
•   What kind of discount can we expect in the Doughnut Hole?
•   I'm trying to figure out when I will go in the donut hole. Also, my brand name Rx costs about $1800 a month. In the Donut Hole will the $1800 go toward my out of pocket costs (TrOOP) - or will I only get a credit for my 50% discount or $900?
•   What do I pay when the purchase of my medications moves me from my regular coverage into the Donut Hole? Do I get coverage from my plan or do I receive the Donut Hole Discount?
•   How much money could I possibly save with the 2011 Donut Hole Discount?
•   If the total cost of one drug purchase takes my annual cost over my Medicare plan's coverage limit and into the Donut Hole, will I pay the copay for my drug plus 50% of the cost that is over the coverage limit?
•   I am enrolled in a Medicare Part D plan and just entered the Donut hole. Now my Medicare drug plan said that I couldn’t get a 50% discount on one of my formulary medications because it was not on the list of eligible drugs. How can that be?

Medicare Plan Quality Star Ratings
[ All FAQs In This Category ] 
•   Is there any danger if I use the 5-star Special Enrollment Period?
•   What do the Medicare plan ratings measure?
•   What are the Medicare Plan Ratings?

Monthly Formulary Changes
[ All FAQs In This Category ] 
•   Besides dropping a medication from my formulary, what other changes can my Medicare prescription drug plan make to my formulary during the year?
•   What should I do if my medication is dropped from my drug plan formulary and the generic form of the medication does not work for me?
•   So, is it possible that my Medicare Part D plan could drop any of my medications from my plan’s formulary - at any time?
•   I was notified by my Medicare plan that my medication was not dropped, but instead now requires that I get prior authorization before my prescription is filled. Can a plan make such changes as this?
•   One of my medications, Lipitor, is being dropped from my plan next month because my plan now covers the generic Atorvastatin. Are Medicare drug plans allowed to change their drug list during the year?
•   Will my Medicare Part D plan provide me with a notification that they are changing my plan’s drug list?

General Medicare Part D
[ All FAQs In This Category ] 
•   My COBRA ends on 4/15 whereas Part D plans begin on the first of the month. When should I enroll?
•   What is meant by the abbreviations: EA BA DS AE in the plan benefit type?
•   Medicare Part D? What is it? How do I do to get it? Who pays for it? How do I enroll?
•   What are the United States territories that are also covered by Medicare Part D prescription drug plans? Is there a way to see the Medicare Part D plans offered in these U.S. Territories?
•   Where can I get a Medical Power of Attorney form?
•   What is Public Law No: 110-275 - Medicare Improvements for Patients and Providers Act of 2008 or MIPPA?
•   What are the CMS Medicare Part D prescription drug plan regions?
•   How many companies will be offering a Medicare Part D prescription drug plans on a national basis?
•   Do people who sell Medicare drug plans have to be licensed insurance agents?
•   Will the drugs covered by Medicare drug plans meet the needs of both seniors and people with disabilities?
•   What is Medicare Prescription Drug Coverage?
•   Is Medicare and Humana the same thing? Do they both have the same benefits? Does Humana pay more for medication than Medicare? Please explain.
•   What are Tiers in Medicare Part D?
•   What is Step Therapy in Medicare Part D?
•   What is a Quantity Limitation in Medicare Part D?
•   What is a Qualified Medicare Beneficiary (QMB) in Medicare Part D?
•   What is a Prior Authorization in Medicare Part D?
•   What is a Plan Name in Medicare Part D?
•   What is Part B (Medical Insurance)?
•   What is Part A (Hospital Insurance)?
•   What are PACE (Programs of All-inclusive Care for the Elderly) Programs?
•   What is an Original Medicare Plan?
•   What is the Monthly Premium in Medicare Part D?
•   What is a Medicare Advantage Special Needs Plan (SNP) and can anyone join a SNP?
•   What is a Medicare Savings Program?
•   What is a Medicare Prescription Drug Plan?
•   What is a Medicare Medical Savings Account (MSA) Plan?
•   What is a Medicare Health Plan and how does it compare to a Medicare Advantage Plan?
•   What is a Medicare Cost Plan in Medicare Part D?
•   What is a Medicare Advantage Plan?
•   If I Qualify for Extra Help, will My Full Premium be Covered?
•   What is a Generic Drug?
•   What is Gap Coverage according to the Medicare Part D Plans?
•   What is a Formulary in the Medicare Part D Plans?
•   What is an Employer or Union Retiree Plan as defined in Medicare Part D?
•   What is a Demonstration/Pilot Program in Medicare Part D?
•   What is the Deductible in the Medicare Part D Plans?
•   What is Cost Sharing in Medicare Part D?
•    Is anybody doing something about coverage for Niaspan?
•   What happens after the Out of Pocket Threshold or True Out of Pocket Cost or TrOOP limit (in 2006 = $3600 and up to $4,350 in 2009) has been met?
•   How can I get financial "extra help" with my medication or Medicare Part D prescription drug costs?

Medicare Advantage Plans
[ All FAQs In This Category ] 
•   I am currently enrolled in Medicare Part A, Part B, and Part D - but not in a Medicare Advantage plan. Will I be required to enroll in some private HMO or PPO when the ObamaCare plan is put in full action?
•   What are Coordinated Care Plans?
•   Can we find more information about Medicare Advantage plans on the Q1Medicare.com site?
•   Is a Medicare Advantage plan the best choice for most people?
•   Are all Medicare Advantage Plans pretty much the same?
•   I already have a Medicare Supplement Plan, can I also enroll in a Medicare Advantage Plan?
•   If I am not happy in my Medicare Advantage plan, can I go back to my Original Medicare Part A and Part B or my old Medicare Supplement coverage?
•   Are Medicare Advantage Plans the same as Medicare Supplements?
•   What is a Health Maintenance Organization (HMO) Medicare Advantage Plan?
•   Can anyone join a Medicare Advantage Plan?
•   What is an HMO POS Medicare Advantage Plan?
•   Will I lose my original Medicare Part A and Part B coverage if I enroll in Medicare Advantage Plan?
•   Is there really any difference between a Medicare Part D Prescription Drug Plan and a Medicare Advantage Plan?
•   Can an insurance company drop you from their Medicare Advantage Plan or can you continue on it indefinitely?
•   What is a Private Fee-for-Service Plan (PFFS) in Medicare Part D?
•   What is a Preferred Provider Organization (PPO) Medicare Advantage Plan?
•   What is a Medicare Advantage Special Needs Plan (SNP) and can anyone join a SNP?
•   What is a Medicare Medical Savings Account (MSA) Plan?
•   What is a Medicare Health Plan and how does it compare to a Medicare Advantage Plan?
•   What is a Medicare Advantage Plan?

Before Enrolling in a Medicare Prescription Drug Plan
[ All FAQs In This Category ] 
•   Why aren't the United Healthcare advantage plans that are available in VA shown on your list?
•   What do the Medicare plan ratings measure?
•   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?
•   Who actually calculates the amount of my late-enrollment penalty?
•   If I enroll in a Medicare prescription drug plan that has an initial deductible, will it have any impact on when I go into, or out, of the Doughnut Hole or Coverage Gap?
•   Medicare Part D? What is it? How do I do to get it? Who pays for it? How do I enroll?
•   What is the Initial Coverage Limit or drug cost ceiling before going into the donut hole or coverage gap? The limit seems to vary between Medicare Part D plan providers.
•   Does prescription drug coverage under a Medigap (or Medicare Supplement) plan H, I or J qualify as “creditable coverage” for purposes of avoiding the Medicare Part D late enrollment premium penalty?
•   Where can I get a Medical Power of Attorney form?
•   What do I need to know if I have drug coverage from TRICARE, the Department of Veteran's Affairs (VA), or the Federal Employee Health Benefits Program (FEHB)?
•   Will my drugs be covered?
•   Should I join a Medicare drug plan even if I don't take many prescription drugs?
•   What are the out-of-pocket costs for Medicare prescription drug coverage?
•   Do I have to join a Medicare drug plan?
•   Can I use my regional drug plan all over the country?
•   Is there someone to help me choose a Medicare prescription drug plan?
•   What other information should I (or can I) consider when choosing a Medicare Part D plan?
•   Where can I get additional help with choosing a Medicare Part D plan?
•   When selecting a Medicare Part D plan for this year, is choosing the cheapest plan better (that is, choosing a plan with the lowest cost monthly premium)?
•   I joined [a Medicare Part D plan] in May 2006. Will my new year start in may 2007 or january 2007
•   Do any Medicare Part D plans ever cover extended drugs beyond the normal Medicare Part D formulary?
•   Is it true that the WellCare Signature plan has a $0 deductible and a $0 generic drug co-pay?
•   What is a Copayment in the Medicare Part D Plans?
•   What is Coinsurance for the Medicare Part D Plans?
•   What is the meaning behind Cobrands or Cobranding Medicare Part D Plans?
•   What is the Approval Status of a Presciption Drug Plan?
•   What actually is the Annual Deductible?
•   How do I contact AmeriHealth Advantage Medicare Part D Prescription Drug Plans?
•   What is the contact information for the Advantage Star Plan - Medicare Part D Prescription Drug Plan?
•   What is the contact information for the SierraRx Prescription Drug Plans.
•   What is the contact information for the YOURx Medicare Part D plans?
•   I presently receive my prescriptions from the Veterans Administration (VA) - how does the prescription drug coverage from the VA work with the Medicare Part D plans?
•   I am on Medicare part A and B. My wife works and we have prescription drug insurance through her present employer. What do I have to do? Will I be able to get on Medicare Part D if she retires in a few years or looses her job?
•   Where can I download a copy of the Humana Formulary
•   Where can I find the formulary for the Coventry AdvantraRX plans?
•   I turn 65 on September and will not have Medicare until that month. So when do I register for Part D.
•   What is Co-Insurance?
•   What is Co-Payment or Co-Pay?
•   What are the Humana co-pays for meds? Is there a way to get a 90 day supply?
•   Can I have a medicare supplement plus medicare prt d and what would the premium cost.
•   Please clearly explain the cost of the prescripts they will use for the out of pocket expense.
•   I need to be enrolled into a rx plan. I am disabled and have Hospital part A and Medical part B. Does Highmark Security( medco )blue have a rx plan for me

•   I would like to know if a list exists which shows company, pdp plan name, bin, PCN, Group #, phone on it?

•   How does this work? I see now that I have to choose a plan. Does SS take money out of my account for this? What is the cost of the plans? Are you charged whether you use it or not? I called Medicare 3 times and was disconnected.
•   I live in New Jersey during the summer and in Florida in the winter. Do I need to purchase two plans?
•   I AM ON DISB, AND SSI SO WHY IS IT THAT IT IS ALL DIFF NOW TELL ME HOW I CAN GET ALL THE SAME STUFF I HAD BEFORE AND NOT ALL THIS RUNNING AROUND SHIT
•   My friend receives extra help, but enrolled in the Unicare premier part D plan. At the pharmacy her copay is $10 and $30. Unicare said that if she qualifies for extra help, she has to enroll in the value plan. Is this true? What should she do now?
•   I plan to enroll in a Part D program sometime in May to avoid the higher premium. My question is will there be any additional cost if I just add the Plan D to my existing plan
•   I am covered under Humana Gold Choice for my part D prescription coverage. I would like to know what exact coverage I have.

•   What will my drugs cost in the donut hole? Negotiated price of insurer or retail price? How can I find out my cost of drugs in the donut hole?

•   It is my understanding that I need to give you the names of the drugs I take to find out if you would provide me with the insurance I need. Is this so, or do I need to wait until I receive your application and return it to see if we are approved.
•   I am comparing plans for WA state. What is the email address or site for Humana Inc.?
•   I have chosen a plan, but I am waiting on info package. However, I need to find out what medications are on Tier One or Two would match one I'm on in Tier three. My doctor is willing to work with me, but neither of us know where to look.

•   Do most of the major providers have plans for individuals that also are low income and have a secondary medical plan of medicaid?

•   I am trying to select a new Medicare Part D Plan and I need help! How do you choose a Medicare Part D plan?

Medicare Part D Enrollment
[ All FAQs In This Category ] 
•   My COBRA ends on 4/15 whereas Part D plans begin on the first of the month. When should I enroll?
•   I do not use any medicatons at this time, so if I decide not to enroll in a Medicare Part D prescription drug plan next year does that prevent me from enrolling in future years?
•   I am enrolling in a new Medicare Part D plan for next year. I still have enough of a 90 day prescription left to last me until February. Can I make my part D plan effective February 1 to save the cost of the January Part D premium?
•   Do any companies offer a non deductible and no pay in the donut hole? In the beginning of he Part D program they did for a higher premium then it was stopped.
•   I just selected a Medicare Part D plan and now the CMS Part D plan ratings are online. Are the Plan ratings really important?
•   Last year, my Part D prescription drug coverage was delayed because of a problem with my enrollment application. How can I avoid this problem this year?
•   I didn’t enroll in a Medicare Part D plan when I was first eligible, how will I calculate my Part D premium penalty?
•   Should I send a monthly payment in with my Medicare Part D enrollment form?
•   What is the Initial Coverage Limit or drug cost ceiling before going into the donut hole or coverage gap? The limit seems to vary between Medicare Part D plan providers.
•   I enrolled in a Medicare Part D plan during the annual Open Enrollment Period, then, I changed my mind and enrolled in Medicare Advantage plan that includes drug coverage. What happens if I enrolled in more than one plan during the enrollment period?
•   When I enroll in a new Medicare Part D prescription drug plan, do I need to dis-enroll from my old Medicare Part D plan or do I need to notify the current prescription drug plan about the change?
•   What are the Annual Enrollment Period dates?
•   I am a recent State of Georgia retiree. I had United HealthCare medical coverage and need to select a Part D plan. I would like to stay with United HealthCare. What are my options?
•   Where can I get a Medical Power of Attorney form?
•   What should I do if I have drug coverage through an employer or union and will also get the extra help with my drug costs?
•   How will my Federal Employee Health Benefits (FEHB) work with my Medicare prescription drug coverage?
•   How will my TRICARE coverage work with my Medicare prescription drug plan?
•   What do I need to know if I have the Original Medicare Plan (Medicare Part A and Part B) and I don't have prescription drug coverage?
•   When can I join a Medicare drug plan?
•   If I have a disability and receive Medicare benefits before age 65, can I also sign up for a Medicare Part D drug plan at the same time? What if I decide NOT to join a Part D plan, do I pay a penalty if I decide to join a Part D plan later?
•   Do you offer Medicare Part D plans for West Virginia?
•   Do you offer Medicare Part D plans for Washington, DC?
•   Do you offer Medicare Part D plans for Washington?
•   Do you offer Medicare Part D plans for Texas?
•   Do you offer Medicare Part D plans for Rhode Island?
•   Do you offer Medicare Part D plans for Pennsylvania?
•   Do you offer Medicare Part D plans for South Dakota?
•   Do you offer Medicare Part D plans for North Dakota?
•   Do you offer Medicare Part D plans for South Carolina?
•   Do you offer Medicare Part D plans for North Carolina?
•   Do you offer Medicare Part D plans for New Jersey?
•   Do you offer Medicare Part D plans for Mississippi?
•   Do you offer Medicare Part D plans for Idaho?
•   Do you offer Medicare Part D plans for Montana?
•   Do you offer Medicare Part D plans for Connecticut?
•   Do you offer Medicare Part D plans for Massachusetts?
•   Do you offer Medicare Part D plans for Wyoming?
•   Do you offer Medicare Part D plans for Wisconsin?
•   Do you offer Medicare Part D plans for Virginia?
•   Do you offer Medicare Part D plans for Vermont?
•   Do you offer Medicare Part D plans for Tennessee?
•   Do you offer Medicare Part D plans for Utah?
•   Do you offer Medicare Part D plans for Oregon?
•   Do you offer Medicare Part D plans for Oklahoma?
•   Do you offer Medicare Part D plans for Ohio?
•   Do you offer Medicare Part D plans for New York?
•   Do you offer Medicare Part D plans for New Mexico?
•   Do you offer Medicare Part D plans for Nevada?
•   Do you offer Medicare Part D plans for Nebraska?
•   Do you offer Medicare Part D plans for Missouri?
•   Do you offer Medicare Part D plans for Minnesota?
•   Do you offer Medicare Part D plans for Michigan?
•   Do you offer Medicare Part D plans for Maryland?
•   Do you offer Medicare Part D plans for Maine?
•   Do you offer Medicare Part D plans for Louisiana?
•   Do you offer Medicare Part D plans for Kentucky?
•   Do you offer Medicare Part D plans for Kansas?
•   Do you offer Medicare Part D plans for Iowa?
•   Do you offer Medicare Part D plans for Indiana?
•   Do you offer Medicare Part D plans for Illinois?
•   Do you offer Medicare Part D plans for Hawaii?
•   Do you offer Medicare Part D plans for Georgia?
•   Do you offer Medicare Part D plans in Florida?
•   Do you offer Medicare Part D plans in Delaware?
•   Do you offer Medicare Part D plans in Colorado?
•   Do you offer Medicare Part D plans in California?
•   Do you offer Medicare Part D plans in Arkansas?
•   Do you offer Medicare Part D plans in Arizona?
•   I live in Alaska, do you offer Medicare Part D plans for me?
•   I live in Alabama, do you offer Medicare Part D plans for me?
•   I enrolled into a Medicare Part D prescription drug a few weeks ago and I still have not heard anything from my new plan! How long will it take before I receive any information from the Medicare plan?
•   How do I contact WellCare about my Medicare Part D enrollment?
•   How do I enroll in a Medicare Part D plan?

The Late-Enrollment Penalty
[ All FAQs In This Category ] 
•   I do not use any medicatons at this time, so if I decide not to enroll in a Medicare Part D prescription drug plan next year does that prevent me from enrolling in future years?
•   Who actually calculates the amount of my late-enrollment penalty?
•   I didn’t enroll in a Medicare Part D plan when I was first eligible, how will I calculate my Part D premium penalty?
•   Does prescription drug coverage under a Medigap (or Medicare Supplement) plan H, I or J qualify as “creditable coverage” for purposes of avoiding the Medicare Part D late enrollment premium penalty?
•   If I have a disability and receive Medicare benefits before age 65, can I also sign up for a Medicare Part D drug plan at the same time? What if I decide NOT to join a Part D plan, do I pay a penalty if I decide to join a Part D plan later?
•   I moved to a different state where my prescription drug plan offers no coverage (it was a local plan in my former state). How do I avoid a premium penalty increase when I have to join a new Part D plan?

Medicare Enrollment Periods
[ All FAQs In This Category ] 
•   What are the differences between the Medicare Part D AEP, Annual Election Period, Annual Enrollment Period, annual Open Enrollment Period, and the Annual Coordinated Election Period?
•   I will turn 65 in February. When should I enroll in Medicare?

Special Enrollment Periods (or SEPs)
[ All FAQs In This Category ] 
•   I plan to move from Miami to New Orleans next month and I don't want to get a penalty for being without a Medicare plan. What is the Special Enrollment Period when moving outside of my current Medicare Advantage plan's service area?
•   We just moved from North Carolina to Florida and our Medicare plan was cancelled because of our relocation. Can we enroll back into our same Medicare plan now (July) or do we have to wait until November/December?
•   Is there any danger if I use the 5-star Special Enrollment Period?
•   Where can I learn about which special enrollment periods are available

Switching Medicare Part D Plans
[ All FAQs In This Category ] 
•   Will I lose my original Medicare Part A and Part B coverage if I enroll in Medicare Advantage Plan?
•   Why did the monthly premium of my Medicare prescription drug plan almost double?
•   I want to switch plans for next year. Do I have to contact my old plan?
•   How is a person's previous prescription drug spending (or True Out of Pocket costs - TrOOP) affected if a Medicare Part D beneficiary switches Medicare Part D prescription drug plans?
•   I wish to cancel my Medicare Part D prescription drug plan coverage. What should I do?
•   When and how often can I switch my Medicare drug plan?
•   What happens if I change plans and request automatic premium deductions from my Social Security benefits for my new plan, but the premium deduction from my previous plan doesn't stop?
•   What happens if I have automatic premium deduction from my Social Security benefit and I switch to a different Medicare drug plan later? Will the automatic premium deduction carry over to my new drug plan?
•   I want to know if if there are any [Medicare Part D] plans that pay for all drugs through the donut hole or coverage gap? A few years ago, I found a plan with complete donut hole coverage and hope there will be some new plans in the future.
•   When selecting a Medicare Part D plan for this year, is choosing the cheapest plan better (that is, choosing a plan with the lowest cost monthly premium)?
•   How do I know if I have enrolled in the most cost-effective plan?
•   How do I cancell (dis-enroll) from my plan?
•   i disenrolled from my Humana Medicare Part D Olan in error by phone a couple days ago and i wish to stay enrolled in my plan.
•   I have signed up and been accepted in a plan. Since then I have found another plan that is a lot cheaper can I drop the plan I have have signed up with?
•   How can I change the plan I have selected? What is the procedure???

Living with your Medicare Part D Plan
[ All FAQs In This Category ] 
•   I am being charged list price for my generics. I don't understand why.
•   I cannot find a phone number for contact purposes regarding a claim denial.
•   Why is xanex or alprazolam not included in the drug formulary list? Some people had the need for the drug and you have a lot stronger drugs that are included. What is the reasoning on this?
•   When I am in my Medicare Part D plan's Donut Hole or Coverage Gap, how much do I actually pay? I have already reached my 2012 Medicare Part D prescription drug plan's initial coverage limit of $2930. So what do I pay?
•   My husband has already reached the "donut hole" this year. Beginning January 1, 2012 will his coverage start over and he will be out of the "donut hole" or will he continue to be in the "donut hole" in 2012 until the $4700 out of pocket is satisfied?
•   For 2011 you indicate that the full retail cost of drugs while in the donut hole will apply to the amount required to get out for name brands even though I'm only paying 50%. Can you clarify?
•   Although I understand that brand name drugs will be discounted 50% in the donut hole in 2011, my Medicare Part D plan’s monthly summary still shows that I will be responsible for 100% in what they term stage 2. Is this an error?
•   I wanted to purchase a few medications without using my Medicare Part D plan and my local pharmacy said that I had to use my Medicare Part D card when purchasing my prescriptions. The pharmacy said it was illegal not to use my Medicare Part D plan.
•   How much do I have to pay for generics in the donut hole in 2011, 2012, 2013,2014, 2015, etc. until it reaches 25%
•   How do I know when I will reach my Medicare Part D plan's Donut Hole or Coverage Gap?
•   What should I do now that I am in the Donut Hole or Coverage Gap? Is there any way to save money or are there programs available to help people like me pay for my prescription drugs?
•   What happens when we buy our prescriptions or medications in advance? For instance, what occurs if we buy a three-month supply of medication through mail order does this have any effect on when we enter the doughnut hole or coverage gap?
•   I am spending a lot of money on drugs and my Part D plan. What part of my spending is not counted toward my prescription drug plan's Donut Hole?
•   You say that I will enter my Medicare Part D plan's Doughnut Hole or Coverage Gap when my retail drug costs reach a certain dollar level that changes yearly. What exactly do you mean by "retail drug costs"? Is that what I spend on my pharmacy drugs?
•   When does a Medicare Part D beneficiary enter and exit the doughnut hole or coverage gap? The Doughnut Hole calculators seem to provide an estimate. But how does a beneficiary really know exactly when they enter and leave the coverage gap?
•   Why is Fioricet with codeine covered under Medicare Part D but not plain Fioricet?
•   How does the Maryland SPDAP $1,200 Coverage Gap Subsidy work?
•    I purchased these test strips and had to pay for them even though they are part of my diabetic supplies. The pharmacist said Medicare would refund this money, but they never have. Should my Medicare Part D plan reimburse these supplies?
•   How does the premium grace period work on Medicare Part D plans?
•   What are Medicare Part D plans required to do before an individual is disenrolled from the plan?
•   Can a plan disenroll a person with Medicare if they didn't pay their monthly premium?
•   If I have difficulty using my new Medicare Part D prescription drug plan, is there anything I can do?
•   I need to know how to file a formal complaint with Medicare (CMS) regarding a Medicare Part D plan
•   I never got a report from my Part D carrier concerning my account or how close I was to the donut hole. Shouldn't the Part D plans keep clients like me informed?
•   Why did the monthly premium of my Medicare prescription drug plan almost double?
•   I want to keep my current plan for next year. What do I do?
•   What is the BIN, PCN, and GROUP for my WellCare Medicare Part D prescription drug plan?
•   What exactly is TrOOP or True Out of Pocket costs?
•   What are "Straddle Claims"?
•    Will I be able to use my drug store drug discount card (not a Medicare-approved drug discount card) with a Medicare drug plan?
•   Does Medicare Part D pay for the shingles vaccine?
•   I wish to cancel my Medicare Part D prescription drug plan coverage. What should I do?
•   What if I have a prescription for a drug that isn't on my plan's list of covered drugs (formulary)?
•   Can my doctor ask for an exception on my behalf?
•   What is an Appeal?
•   What is an Exception?
•   What if the drug I need requires "prior authorization?"
•   What happens if a drug covered by my Medicare drug plan is found to be unsafe?
•   What happens if a drug I take stops being covered for a reason other than safety?
•   Will my Medicare Prescription Drug Plan need to notify me if its list of covered drugs (formulary) changes?
•   Can it take longer than a couple of months for the deduction to start?
•   I have requested automatic premium deduction from my monthly Social Security benefit. How long will it take for the automatic deduction to start?
•   This year my Medicare Part D plan told me that Clonazepam is not covered under my Part D plan. However, my mother has the exact same Part D plan as I do and the Part D provider covers this medication for her.
•   Does my Medicare Part D plan also provide Silve Sneakers coverage? I want to join a work out program but i'm not sure my [Medicare Part D Plan] will help me pay for it.
•   Where can I get the forms needed for Humana's RightSource 90 day supply?
•   Is Ambien covered by any carrier???
•   What happens if I drop my present Part D plan because of insuficient use. Then, what happens if I were to reenroll at a later date (possiblly in 3 or 4 years?). Niether my Wife nor myself have even come close to the $250.00 initial deductible.
•   How do I contact AdvantraRx?
•   If I combine my Norvasc and Lipitor prescriptions to Caduet will it cost me less ?
•   I enrolled online for medicare Part D and received my letter saying they were deducting $50 out of my Social Security checks. I wanted a plan to help me pay for my glasses. If part D doesn't help with the cost of glasses, then please cancel my part D.
•   My father has lost his Humana Prescription Drug Plan card. how do I go about getting him a replacement card? Thank you!
•   Help. I signed up for AARP's RX plan and then changed my payment plan in April 06 from the auto-deduction method from my Social Security Check - but the payment method changed to both Social Security Deduction and checking account deduction.
•   How do I learn more about WellCare's Coverage Determination or Drug Evaluation Reviews or formulary Exception Requests.
•   How do I contact Humana?
•   What is the procedure for getting medications by mail on the AdvantraRx plans?
•   Is Niaspan® covered by the Humana (or any other) Medicare prescription drug plans?
•   How do I contact Humana about my Medicare Part D plan?
•   I received a phone message from Humana saying that they will deduct Jan, Feb & Mar payments from my social security check in March. This is not what I wanted, what do I do?
•   I enrolled in a Humana Medicare Part D plan, but I was charged the full or wrong price for my Medication! How do I get reimbursed for my out of pocket expenses?
•   I enrollled in the wrong Humana Medicare Part D plan - I wanted the Enhanced plan, but signed up for the Standard Plan.
•   How do I change the method of payment for my Humana Medicare Part D plan?
•   My name is mis-spelled or incorrect on my Humana Medicare Part D ID card - how do I get this corrected?
•   How do I contact Humana when I have a question about my Medicare Part D plan?
•   I am having trouble accesssing myHumana. Now I can't find the website!
•   What happens after the Out of Pocket Threshold or True Out of Pocket Cost or TrOOP limit (in 2006 = $3600 and up to $4,350 in 2009) has been met?
•   How do I get a prior authorization form for Humana?
•   I enrolled in December 2005 for a February 2006 effective date. Why did I receive a card with a January 2006 effective date?
•   How can I change my Humana payment option?
•   How do I create an online account on the Humana website.
•   How do I get a Letter of Coverage from Humana
•   How can I check to see if my Aetna plan is active?
•   I signed up for a part D drug plan- Blue MedicareRX in December but I have not recieved my card. I am not sure who to contact.

•   where can I find what my co-pay is on the Humana plans in Arizona.
•   How can I file a claim under the Humana Plans?
•   How can I check my enrollment status under the Humana plans?
•   I enrolled on the internet in the medicare Part D, Advantage Freedom Plan. They did not send me a letter acknowledging me as being enrolled. I need their phone # and I can't find the information or the web page.
•   I accidently shredded my new card with some other stuff. I need a replacement card. I do not know the number cause it was not listed anywhere else that I know of. HELP

•   I need to know exactly what you need from the doctor for me to get my Forteo prescription filled.

•   I'm a home health nurse evaluator for home health agency and would like to know if medicare part D will begin to cover home Iv infusion therapy or will it vary from plan to plan? Please advise.
•   My membership was to become effective on June 1, 06 not 01/01/06 My Agent doesn't understand it either. He also mentioned that HUMANA does not have Copayment authority here in Rhode Island. My monthly premium should be around $7.00 and change.
•   Where do I get a list of the number of pills I can get at one time under the Humana plans
•   I need the Humana form to order prescriptions by mail.
•   Can you inform me of any type of mail order program for medications for which a three months supply can be ordered in order to save money? If so please email me along with the instructions and list of medications available to this program. Thank you

•   I am a new blue medicare Rx Value menber under your new plan for prescription drug plan. how much do i have to pay out of my pocket & were do i go fo my prescription to be fill.
•   A recorded msg said plan d payment book would be here mid-jan but nothing has arrived. what is monthly/annual payment? where do i send it? help pls.
•   I was entered into the wrong plan! I was about to use my Humana card and was told that it has the wrong code for my County. My number is CMS S5884 016. My wife's Plan number is the same except hers ends with 010.
•   How do I find out if my Humana Medicare Part D plan is active?

Lower Cash Pricing
[ All FAQs In This Category ] 

Paying Your Premiums
[ All FAQs In This Category ] 
•   This year, I changed from a Medicare Part D plan that costs $40 per month to a Medicare plan that has a monthly premium of only $15. However, the $40 premium was deducted from my January Social Security check. Why was the wrong monthly premium deducted?
•   When will the Social Security Administration begin deducting my Medicare plan premium payments from my monthly Social Security check?
•   Am I allowed to pay my monthly Medicare Part D premiums on an annual or semi-annual basis?
•   I noticed that there are many different ways to pay our monthly Medicare Part D premiums. Is there one way to pay that is better than the others?
•   I believe that I have signed up for automatic withholding, but I have received a notice from my plan that I still owe premiums. What should I do?
•   If I have already enrolled into a Medicare Part D plan, can I still change how I pay my monthly plan premiums?
•   How soon will I get a refund of any premiums that are withheld for my current plan after I enroll in a new plan? Who will the refund come from?
•   How do I pay my premiums until the automatic deduction starts?
•   Where should I call if I have other questions about options for paying my Medicare drug plan premiums, or about withholding premiums from my Social Security payment?
•   What if my monthly Social Security benefit isn't enough to cover multiple premiums at one time?
•   What options do I have for paying my Medicare drug plan premiums?

Pharmacies and Part D
[ All FAQs In This Category ] 
•   I changed Medicare Part D plans this year, but I still plan to get my medications at the same pharmacy as last year. Will my prescriptions transfer to the new drug plan?
•   If I just joined a new Medicare Part D prescription plan, do I need to change pharmacies in order to pay the lowest prices for my medications?
•   I just picked up my medications and it cost me more than I expected. My pharmacy told me that they are not one of my new Medicare plan’s preferred pharmacies and so prescriptions will cost more – how can this be?
•   The pharmacy couldn't fill my prescription. What should I do?
•   One article I recently read suggested that we could obtain a 3 months prescription supply for the cost of two monthly co-payments at preferred pharmacies. Is this correct? A local pharmacy said I would have to bring in my Rx Card to find out.
•   What is a Preferred Pharmacy in Medicare Part D?
•   What is a Non-preferred pharmacy in Medicare Part D?
•   I went to the pharmacy and they charged full price for my medicaitons instead of the Humana $30 co-pay, why?
•   How can the Pharmacy see if my Medicare Part D plan is active?
•   I received my card and my last name is mis-spelled. My pharmacy won't fill my prescription because my name is spelled wrong.
•   What pharmacies do Medicare Part D plans like Humana or UnitedHealthcare use.

Traveling and Medicare Part D
[ All FAQs In This Category ] 
•   I'll be on a 2 year assignment in Vietnam. Should I/Can I suspend my Medicare Part B?
•   If I travel outside of the United States, purchase prescription drugs while outside of the country and bring them back on my return trip, will my Medicare Part D plan reimburse me for these medications if they are on my plan’s formulary?
•   We are planning a trip across the country and we probably will need to use our Medicare Part D prescription drug plans as we travel. Will we still have prescription coverage outside of our home state?

Moving and Medicare Part D
[ All FAQs In This Category ] 
•   I plan to move from Miami to New Orleans next month and I don't want to get a penalty for being without a Medicare plan. What is the Special Enrollment Period when moving outside of my current Medicare Advantage plan's service area?
•   We just moved from North Carolina to Florida and our Medicare plan was cancelled because of our relocation. Can we enroll back into our same Medicare plan now (July) or do we have to wait until November/December?
•   I'm enrolling in a Medicare Part D prescription plan this month and would like to find a Part D plan that can be transferable to another state - just in case I decide to move. Is there some type of "national" Medicare Part D coverage?
•   If I am in the coverage gap and I move outside of my Service Area and have to switch Medicare part d plans, will I still be in the coverage gap in the new plan or does it start all over?
•   I moved to a different state where my prescription drug plan offers no coverage (it was a local plan in my former state). How do I avoid a premium penalty increase when I have to join a new Part D plan?

Explanation of Benefits (EOB)
[ All FAQs In This Category ] 
•   When I am in my Medicare Part D plan's Donut Hole or Coverage Gap, how much do I actually pay? I have already reached my 2012 Medicare Part D prescription drug plan's initial coverage limit of $2930. So what do I pay?
•   Although I understand that brand name drugs will be discounted 50% in the donut hole in 2011, my Medicare Part D plan’s monthly summary still shows that I will be responsible for 100% in what they term stage 2. Is this an error?
•   I read that my negotiated retail prescription drug costs go toward meeting my Initial Coverage Limit before reaching my Medicare Part D plan's Donut Hole, but is this the normal retail drug cost or the total cost in my Explanation of Benefits letter?
•   How do I know when I will reach my Medicare Part D plan's Donut Hole or Coverage Gap?

Straddle Claims
[ All FAQs In This Category ] 
•   I have a prescription with a retail cost of $1,894 and I have already purchased medications with a total retail cost of $930. If my Medicare Part D prescription drug plan has an Initial Coverage Limit of $2,600, will I pay the full price?
•   If I have not yet met my initial deduction when I have fill a $1500 prescription, will any of the $1500 be applied to the my coverage [initial coverage phase], or will I have to pay the whole $1500 before my coverage goes in to effect?
•   Can you provide an example of the Medicare "Lesser Of" logic?
•   I have a Medicare Part D prescription drug plan with a $310 initial deductible. What do I pay when I refill my prescription and a single purchase moves me from my initial deductible into the part of my plan where I get paid coverage?
•   Does the Donut Hole Discount apply to a retail drug purchase that straddles my Medicare Part D plan's Initial Coverage phase and the Coverage Gap or Donut Hole phase? In other words, does the Donut Hole discount apply to a Straddle Claim?
•   What are "Straddle Claims"?

How Your Medicare Plan Can Change (ANOC)
[ All FAQs In This Category ] 
•   Once I join a Medicare Part D plan and I am locked-in for the full year, can my Medicare prescription drug plan drop medications from its drug list during the year?

The Coverage Gap or Donut Hole or Doughnut Hole
[ All FAQs In This Category ] 
•   I read that my negotiated retail prescription drug costs go toward meeting my Initial Coverage Limit before reaching my Medicare Part D plan's Donut Hole, but is this the normal retail drug cost or the total cost in my Explanation of Benefits letter?
•   How do I know when I will reach my Medicare Part D plan's Donut Hole or Coverage Gap?
•   What should I do now that I am in the Donut Hole or Coverage Gap? Is there any way to save money or are there programs available to help people like me pay for my prescription drugs?
•   If I have to pay 100% of my own drug costs when I go into the Doughnut Hole, why don’t I just stop paying my monthly Part D plan premiums?
•   Can I avoid the Doughnut Hole if I buy a 90-day supply of my medications with the lower co-payment?
•   I never got a report from my Part D plan showing how close I am to the Doughnut Hole. Shouldn’t I be getting a summary of my prescription drug spending?
•   I think that I have already spent my way through this year's Doughnut Hole. Is that possible?
•   I purchased a Medicare Part D plan with coverage during the Doughnut Hole, so I guess I am protected throughout the year, right?
•   How exactly does the Coverage Gap fit into my prescription drug plan?
•   What costs do NOT count toward entering the Doughnut Hole?
•   Will you enter the Donut Hole or Coverage Gap this year?
•   What happens when we buy our prescriptions or medications in advance? For instance, what occurs if we buy a three-month supply of medication through mail order does this have any effect on when we enter the doughnut hole or coverage gap?
•   If I enroll in a Medicare prescription drug plan that has an initial deductible, will it have any impact on when I go into, or out, of the Doughnut Hole or Coverage Gap?
•   I am spending a lot of money on drugs and my Part D plan. What part of my spending is not counted toward my prescription drug plan's Donut Hole?
•   You say that I will enter my Medicare Part D plan's Doughnut Hole or Coverage Gap when my retail drug costs reach a certain dollar level that changes yearly. What exactly do you mean by "retail drug costs"? Is that what I spend on my pharmacy drugs?
•   When does a Medicare Part D beneficiary enter and exit the doughnut hole or coverage gap? The Doughnut Hole calculators seem to provide an estimate. But how does a beneficiary really know exactly when they enter and leave the coverage gap?
•   What exactly is TrOOP or True Out of Pocket costs?

Getting to Your Donut Hole
[ All FAQs In This Category ] 
•   I currently use two prescriptions and my 2012 Medicare Part D prescription drug insurance does not pay anything for either one of these drugs. Does the retail cost of these two medications add into the calculation towards my 2012 Doughnut Hole?
•   How much would I need to spend per month on prescription drugs to enter the 2012 Donut Hole?
•   My Medicare Part D plan told me that I will go into the 2012 Donut Hole based on what I paid for my medications plus what the insurance company paid. Is this true?

Getting Out of Your Donut Hole
[ All FAQs In This Category ] 
•   If I am in the 2012 Doughnut Hole and I paid $100 for my medications, and the Medicare Gap Discount Program has paid $50, does that total of $150 go towards True Out of Pocket expenses?
•   If I am in the coverage gap and I move outside of my Service Area and have to switch Medicare part d plans, will I still be in the coverage gap in the new plan or does it start all over?

Medicaid & Extra Help & LIS
[ All FAQs In This Category ] 
•   What are the 2011 Federal Poverty Level (FPL) Guidelines
•   Are there any Medicare Part D prescription drug plans that are free for Medicare beneficiaries over the financial limits for Medicaid and Extra Help?
•   How do I search for a Medicare Part D plan that qualifies for the $0 premium Low-Income Subsidy?
•   I have a relative who is getting SSD along with health coverage. His mother just passed away and he will receive a substantial amount of funds from the sale of her estate. Can this effect his health coverage?
•   Is Lifeline (personal response system) a covered benefit under Medicare if there is a medical indication for it?
•   How will people know if their copayment amounts will change?
•   How does this affect people who currently automatically qualify for extra help?
•   What efforts are underway affecting people who qualify for extra help paying for their Medicare prescription drug coverage?
•   What if people don't agree with Social Security's decision on "extra help"?
•   What should people do if they think there's been a mistake determining their eligibility for extra help?
•   Will everyone with extra help get a letter from Medicare or Social Security?
•   How does this affect people who applied and qualified for extra help (i.e., those that did not automatically qualify)?
•   How will people know if they no longer automatically qualify for extra help?
•   What should people do if they no longer automatically qualify for extra help in 2007?
•   How often do I need to apply for the extra help?
•   How often can I change plans if I have Medicare and full Medicaid coverage?
•   What if Medicare doesn't cover my prescription at all? Will Medicaid still pay for it?
•   What information do I need to apply for the extra help?
•   If I am not certain whether or not I qualify, should I apply for extra help?
•   I work in the Senior Community Service Employment Program (SCSEP, Title V of the Older Americans Act). Will Medicare count this as income when determining if I qualify for extra help paying for Medicare prescription drug coverage?
•   What does the term extra help mean when you are talking about Medicare prescription drug coverage?
•   If I qualify for extra help, will my drug plan premium always be $0?
•   What is a Specified Low - Income Medicare Beneficiary (or SLMB)?
•   What is a Medicare Savings Program?
•   What is Medicaid?
•   If I Qualify for Extra Help, will My Full Premium be Covered?
•   Where do I find more information on Tri-Care - for instance, where can I download the Tri-Care Forms?
•   I should be getting "extra help" and am not. What do I do?
•   How can I get financial "extra help" with my medication or Medicare Part D prescription drug costs?
•   I am having trouble getting the extra help that I qualify for at Wal-Mart, and I need to pick up 2 prescriptions that are ready. There is a problem on your end per Medicare & Social Security. Please contact me ASAP so I will know what to do.
•   My son is on Medicaid. He was assigned a Medicare Part D plan and his plan in Georgia does not cover one of his medications. What do we do?
•   I am not suppose to have a deductable. I cannot pay for my medicine. I get State Aid. Help!!!

Other Q1Medicare.com Questions
[ All FAQs In This Category ] 
•   How can I get a 2009 Medicare & You Handbook?
•   I have a relative who is getting SSD along with health coverage. His mother just passed away and he will receive a substantial amount of funds from the sale of her estate. Can this effect his health coverage?
•   Is Lifeline (personal response system) a covered benefit under Medicare if there is a medical indication for it?
•   What are the Medicare premiums and coinsurance rates for 2008?
•   Where can I get a Medical Power of Attorney form?
•   I am asking you this question, because I do not know where or how to look up my question. I want to donate my body when I die, hoping it will help someone else. Can you please tell me a web site to go to.
•   What do I do when a Medicare beneficiary dies?
•   What if I have a prescription for a drug that isn't on my plan's list of covered drugs (formulary)?
•   Do people who sell Medicare drug plans have to be licensed insurance agents?
•   Can my doctor ask for an exception on my behalf?
•   What is an Appeal?
•   What is an Exception?
•   What is a coverage determination?
•   Did letters go out in Spanish to Spanish-language households?
•   How will people know if their copayment amounts will change?
•   How does this affect people who currently automatically qualify for extra help?
•   What efforts are underway affecting people who qualify for extra help paying for their Medicare prescription drug coverage?
•   What if the drug I need requires "prior authorization?"
•   What if people don't agree with Social Security's decision on "extra help"?
•   What should people do if they think there's been a mistake determining their eligibility for extra help?
•   Will everyone with extra help get a letter from Medicare or Social Security?
•   How does this affect people who applied and qualified for extra help (i.e., those that did not automatically qualify)?
•   How will people know if they no longer automatically qualify for extra help?
•   What should people do if they no longer automatically qualify for extra help in 2007?
•   How will my American Indian or Alaska Native health program work with my Medicare prescription drug coverage?
•   How does Pennsylvania's PACE/PACENET auto-enrollment work with Medicare drug plans?
•   How will the Program of All-inclusive Care (PACE) work with my Medicare drug plan?
•   How will my CHAMPVA coverage work with my Medicare prescription drug coverage?
•   How will my State Pharmacy Assistance Program (SPAP) work with Medicare drug coverage?
•   What should I do if I have drug coverage through an employer or union and will also get the extra help with my drug costs?
•   How will my Federal Employee Health Benefits (FEHB) work with my Medicare prescription drug coverage?
•   How will my TRICARE coverage work with my Medicare prescription drug plan?
•   How will my Medigap Policy work with my Medicare prescription drug coverage?
•   What happens if a drug covered by my Medicare drug plan is found to be unsafe?
•   What happens if a drug I take stops being covered for a reason other than safety?
•   What do I need to know if I have the Original Medicare Plan (Medicare Part A and Part B) and I don't have prescription drug coverage?
•   Will the drugs covered by Medicare drug plans meet the needs of both seniors and people with disabilities?
•   What is Medicare Prescription Drug Coverage?
•   Will Medicare drug plans cover drugs that treat mental illness?
•   Will my Medicare Prescription Drug Plan need to notify me if its list of covered drugs (formulary) changes?
•   Do State Pharmacy Assistance Programs (SPAPs) have to work with all Medicare drug plans offered in their states?
•   Are Medicare drug plans allowed to cover benzodiazepines (like sleeping pills)?
•   What do I need to know if I have drug coverage from TRICARE, the Department of Veteran's Affairs (VA), or the Federal Employee Health Benefits Program (FEHB)?
•   How often do I need to apply for the extra help?
•   When can I join a Medicare drug plan?
•   What does a Medicare drug plan cover?
•   Will my drugs be covered?
•   How often can I change plans if I have Medicare and full Medicaid coverage?
•   Should I join a Medicare drug plan even if I don't take many prescription drugs?
•   What if Medicare doesn't cover my prescription at all? Will Medicaid still pay for it?
•   What information do I need to apply for the extra help?
•   What if I need a drug that isnt on the formulary or is covered at a higher cost?
•   What are the out-of-pocket costs for Medicare prescription drug coverage?
•   Will some drugs still be covered under Part B?
•   Are any drug categories not included in Medicare prescription drug coverage?
•   If I am not certain whether or not I qualify, should I apply for extra help?
•   When and how often can I switch my Medicare drug plan?
•   Do I have to join a Medicare drug plan?
•   I work in the Senior Community Service Employment Program (SCSEP, Title V of the Older Americans Act). Will Medicare count this as income when determining if I qualify for extra help paying for Medicare prescription drug coverage?
•   How can I protect myself from Medicare fraud?
•   Will I be able to use my drug store drug discount card with a Medicare drug plan?
•   Will I be able to use more than one Medicare drug plan?
•   Can I use my regional drug plan all over the country?
•   What do people with Medigap policies need to do to get Medicare prescription drug coverage?
•   Will Medicare drug plans have preferred drug lists?
•   Is there a limit on the number of drugs a plan will cover in a given year?
•   What does the term extra help mean when you are talking about Medicare prescription drug coverage?
•   Is there someone to help me choose a Medicare prescription drug plan?
•   I have prescription drug coverage from my former employer. Will I be able to keep it or will Medicare prescription drug coverage replace it?
•   If I qualify for extra help, will my drug plan premium always be $0?
•   Can it take longer than a couple of months for the deduction to start?
•   I have requested automatic premium deduction from my monthly Social Security benefit. How long will it take for the automatic deduction to start?
•   What happens if I change plans and request automatic premium deductions from my Social Security benefits for my new plan, but the premium deduction from my previous plan doesn't stop?
•   What happens if I have automatic premium deduction from my Social Security benefit and I switch to a different Medicare drug plan later? Will the automatic premium deduction carry over to my new drug plan?
•   I am eligible for the "extra help" with prescription drug costs or limited-income subsidy, but my plan is billing me for a premium. What should I do?
•   I will be switching to a different Medicare drug plan. What do I need to do to stop the automatic premium deduction from my current Medicare drug plan?
•   Creditable vs. Non-creditable Employer Retiree Drug Coverage
•   How will my retail pharmacy discount work with with my Medicare drug coverage?
•   How will my employer retiree drug coverage work with my Medicare prescription drug coverage?
•   How will my VA health benefits work with my Medicare prescription drug coverage?
•   How will my other prescription drug assistance program work with my Medicare prescription drug coverage?
•   Who are you?

Higher Incomes and Higher Payments (IRMAA)
[ All FAQs In This Category ] 
•   What can I do if I do not agree with the Social Security Administration's income-related monthly adjustment amount or IRMAA assessment?
•   Can you provide an example of how the income-related monthly adjustment amounts or IRMAA apply to my Medicare Part B and Medicare Part D prescription drug plan premiums in 2012?
•   How is the income-related monthly adjustment amount or IRMAA affected if my income goes down?
•   Which Federal income tax return is used by the Social Security Administration to determine whether I have an income-related monthly adjustment amount for my Medicare Part B and Medicare Part D?
•   How does the Social Security Administration (SSA) determine whether I pay a higher Medicare Part B and Medicare Part D premium?
•   How does the Income-Related Monthly Adjustment Amount (or IRMAA) affect me and my Medicare plan premiums?
•   What is the Income-Related Monthly Adjustment Amount (or IRMAA)?

Q1Medicare.com Tool Tips
[ All FAQs In This Category ] 
•   Can you provide an example of the 2011 Donut Hole Discount?
•   Is there an online tool that shows me all of the prescription drugs covered by a specific Medicare Part D plan?
•   Can we find more information about Medicare Advantage plans on the Q1Medicare.com site?
•   What is the Q1Medicare PDP-Wizard?
•   What is the tool that provides an estimate of the annual drug cost?
•   How do I search for a Medicare Part D plan that qualifies for the $0 premium Low-Income Subsidy?
•   What is the Q1Medicare PDP-Compare tool?
•   What is the Q1Medicare PDP-Finder tool?

Medicare Supplements or Medigap
[ All FAQs In This Category ] 
•   I already have a Medicare Supplement Plan, can I also enroll in a Medicare Advantage Plan?
•   If I am not happy in my Medicare Advantage plan, can I go back to my Original Medicare Part A and Part B or my old Medicare Supplement coverage?
•   Are Medicare Advantage Plans the same as Medicare Supplements?

Carriers and Companies
[ All FAQs In This Category ] 
•   What is the formulary cost tier for Niaspan (the medication for treating cholestorol) on the 2011 Humana Walmart-Preferred Rx Part D prescription drug plan?
•   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?
•   Is Medicare and Humana the same thing? Do they both have the same benefits? Does Humana pay more for medication than Medicare? Please explain.
•   Where can I get the forms needed for Humana's RightSource 90 day supply?
•   My father has lost his Humana Prescription Drug Plan card. how do I go about getting him a replacement card? Thank you!
•   How do I contact Humana?
•   Is Niaspan® covered by the Humana (or any other) Medicare prescription drug plans?

$250 Doughnut Hole Rebate
[ All FAQs In This Category ] 
•   During the 2010 Medicare plan year, my Medicare Part D plan did not cover one of my more expensive medications. The total cost of the medication was never reported to Medicare or my Part D plan. Can I still apply and receive the $250 rebate?
•   I received a $250 rebate check and unfortunately, I threw away the envelope that contained the check. Is it possible that this check is some sort of scam?
•   How do I know if I still qualify for the Medicare Part D $250 Doughnut rebate?
•   How many people actually received their $250 Medicare Part D Donut Hole Rebate check?
•   I received my Part D plan statement and my out of pocket costs are over $700. The total amount of my drug costs are over $2,450 and I will soon reach the $2,830. Do I need to have out of pocket costs or TrOOP reaching $4,550.00 before I'm paid more?
•   I reached the Donut Hole in 2009 when enrolled in my Medicare Part D Prescription Drug Plan. Am I eligible for the $250 rebate recently announced by Medicare?
•   If I am getting Medicare and Social Security, am I still eligible for the rebate?
•   I do not belong to a Medicare Part D plan and actually pay for all of my own prescription drugs. Will I also get the $250 donut hole rebate payment?
•   Who will send me my check my Medicare Part D plan or Medicare?
•   Is the $250 rebate a one-time payment or will I be paid $250 for each month that I am in the donut hole?
•   What exactly is the 2010 Medicare Part D $250 Coverage Gap Rebate?
•   Who Gets the $250 Rebate?
•   Will I still receive the $250 rebate if I am in a Medicare Advantage plan that provides prescription drug coverage (an MA-PD)?
•   If I receive only partial Extra-Help will I receive the $250 rebate?
•   Do I need to do anything to get my $250 rebate?
•    I have already reached the 2010 Doughnut Hole, when can I expect to receive my rebate check?
•   If I reach the 2010 Doughnut Hole later in the year, how long do I need to wait before I receive my rebate check?
•   Is the $250 rebate paid toward my out of pocket costs that I spend on Brand Name drugs?
•   What exactly is the Coverage Gap anyway?
•   Can I estimate when I will reach the 2010 Coverage Gap?
•   Will almost everyone with a Medicare Part D prescription drug plan reach the 2010 Coverage Gap and get a $250 check?
•   How will I know that my rebate check is not part of a Scam?
•   What should I do if I reach the 2010 Doughnut Hole and my $250 rebate check does not arrive?
•   Can I also expect to receive a $250 Rebate next year if I reach the 2011 Medicare Part D Doughnut Hole?
•   I receive my prescription drug benefits from the Veterans Administration (VA) and have not enrolled in a Medicare Part D plan, will I still receive a rebate?
•   I am new to Medicare and just now joining a 2010 Medicare Part D prescription drug plan, am I still eligible for the $250 Doughnut Hole rebate?


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