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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 ...

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 ...

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.....

How do I get a prior authorization form for Humana?
Please have your physician complete and fax the attached document.If your doctor should need to contact Humana regarding a particular medication, they can call 1-800-555-2546 8:00am-6:00pm EST....

What are the 2011 Federal Poverty Level (FPL) Guidelines
The 2011 Federal Poverty Level (FPL) Guidelines determine the income level requirements for people applying for the Low Income Subsidy (LIS) program. If your income is below 135% of the FPL ($14,701.5...

Newest FAQs


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....

How do I calculate my Medicare Part D Late Enrollment Penalty?
Medicare will calculate your Part D Late Enrollment Penalty for you and will send you a letter explaining their calculation, but you can estimate your Late Enrollment Penalty (LEP) by totaling the num...

How do I pay my monthly Medicare Part B premium?
The Medicare website provides you with guidance on paying your Medicare Part B (out-patient and doctor visit coverage) and notes that if you get:Social Security,Railroad Retirement Board (RRB) benefit...

If I have Medicare, can I get healthcare coverage from the Affordable Care Act Health Insurance Marketplace?
No.   Medicare is not included within the ACA Health Insurance Marketplace. If you already have Medicare, you already have healthcare coverage.  In fact, it is against the law for someone...




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