Medicare Part D Prescription Drug Plan Enrollment
When youre eligible to enroll in Original Medicare, you also become eligible to enroll in a Medicare Part D prescription drug plan.
If you want Medicare prescription drug coverage, you typically have two options:
- Enroll in a Medicare Advantage plan that includes prescription drug coverage
- Enroll in a Medicare Part D standalone prescription drug plan
Or call 1-800-557-6059TTY Users: 711 to speak with a licensed insurance agent.
You can also enroll in a prescription drug plan online in as little as 10 minutes when you visit MyRxPlans.com.1
When To Apply For A Medicare Supplement Plan
Medigap open enrollment begins when you sign up for Medicare Part B and lasts for six months. If you defer Part B coverage past age 65 because of health coverage from your employer, this six-month window would start whenever you sign up for Part B. If you want to purchase a Medigap policy, it is crucial that you get your policy within this window.
Everything You Need To Know About This Year’s Sign Up Dates Coverage Costs Eligibility Details And Opportunities To Change Coverage
Right now during the annual Medicare open enrollment Medicare plan enrollees can reevaluate their coverage whether its Original Medicare with supplemental drug coverage, or Medicare Advantage and make changes if they want to do so. | Image: rocketclips / stock.adobe.com
Medicare open enrollment for 2022 coverage ended on December 8, 2021. Learn how you can change your Medicare coverage outside of the fall open enrollment period.
The Medicare Advantage open enrollment period starts on January 1 and continues through March 31. This window, described in more detail below, allows Medicare Advantage enrollees to pick a different Advantage plan or switch to Original Medicare. Just one plan change is allowed during this window.
The general Medicare enrollment period also runs from January 1 to March 31. This window is for people who didnt sign up for Part B when they were first eligible and who do not have access to a special enrollment period for Part B. The general enrollment period can also be used by people who have to pay a premium for Medicare Part A and who didnt enroll in Part A when they were first eligible.
And the five-start Medicare enrollment period is now underway, continuing through November 30, 2022. This window allows you the opportunity to switch to a five-star Medicare plan, if one is available in your area.
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Applying For Medicare With Our Free Assistance
Still concerned about how to sign up for Medicare? Dont want to go in it alone or feel unsure about your Medicare enrollment dates?
You dont have to submit your Medicare application alone. We are here to help you register for Medicare.
If Medicare will be your primary health insurance, and youd like a personal guide to take you from applying for Medicare all the way through to setting up your Medigap and Part D plans, we are your go-to source for help. Our service is free, and afterward you also get access to our Client Service Team for free for the life of your policy.
Get someone on your side contact Boomer Benefits for help with your plan options today!
The Parts Of Medicare
Social Security enrolls you in Original Medicare .
- Medicare Part A helps pay for inpatient care in a hospital or limited time at a skilled nursing facility . Part A also pays for some home health care and hospice care.
- Medicare Part B helps pay for services from doctors and other health care providers, outpatient care, home health care, durable medical equipment, and some preventive services.
Other parts of Medicare are run by private insurance companies that follow rules set by Medicare.
- Supplemental policies help pay Medicare out-of-pocket copayments, coinsurance, and deductible expenses.
- Medicare Advantage Plan includes all benefits and services covered under Part A and Part B prescription drugs and additional benefits such as vision, hearing, and dental bundled together in one plan.
- Medicare Part D helps cover the cost of prescription drugs.
Most people age 65 or older are eligible for free Medical hospital insurance if they have worked and paid Medicare taxes long enough. You can enroll in Medicare medical insurance by paying a monthly premium. Some beneficiaries with higher incomes will pay a higher monthly Part B premium. To learn more, read .
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How Can I Make Changes To My Medicare Advantage Coverage
The fall open enrollment period, which runs from October 15 to December 7 each year, is an opportunity to switch to a different Medicare Advantage plan or to switch to Original Medicare if you think it would serve you better.
If you are already enrolled in a Medicare Advantage plan even if you just signed up during the most recent annual enrollment period and your coverage only took effect on January 1 you can switch to a different Advantage plan or to Original Medicare during the annual Medicare Advantage open enrollment period. This window runs from January 1 to March 31, and has been available since 2019. It only applies to people who are already enrolled in Medicare Advantage plans a person with Original Medicare cannot switch to a Medicare Advantage plan during this window. Instead, that enrollee would need to use the annual enrollment period in the fall to make that change.
If you already have a Medicare Advantage plan and want to switch to a different Advantage plan during general open enrollment or the Medicare Advantage open enrollment period, your existing plan will disenroll you with no lapse in coverage. Any changes you make during general open enrollment will take effect January 1. If you make a change during the Medicare Advantage open enrollment period, it will take effect the first of the following month.
Ready to enroll in new Medicare Advantage or Part D coverage? Discuss your plan options right now with a licensed Medicare advisor. Call
Medicare General Enrollment Period
If you did not enroll during the IEP when you were first eligible, you can enroll during the General Enrollment Period. The general enrollment period for Original Medicare is from January 1 through March 31 of each year. Keep in mind that you may have to pay a late enrollment penalty for Medicare Part A and/or Part B if you did not sign up when you were first eligible.
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Sign Up: Within 8 Months After Your Family Member Stops Working
- If you have Medicare due to a disability or ALS , youll already have Part A .
- Youll pay a monthly premium for Part B , so you may want to wait to sign up for Part B.
Avoid the penalty & gap in coverageIf you miss this 8-month Special Enrollment Period, youll have to wait to sign up and go months without coverage. You might also pay a monthly penalty until you turn 65. The penalty goes up the longer you wait to sign up. How much is the Part B late enrollment penalty?
Who Gets Original Medicare Automatically
The Social Security Administration signs you up for Parts A and B automatically:
- As soon as you turn 65, if you already get:
- Social Security retirement benefits
- Railroad Retirement Board Benefits, or
- Social Security Disability benefits (SSDI
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What Should I Do Next
If youre eligible to enroll in Medicare Massachusetts in 2022, carefully compare Medicare plans to weigh your options.
- Determine the premiums youd like to pay and look for a Medicare Massachusetts plan in your county that will provide the coverage you need.
- Call your doctor to find out what network they belong to and compare a minimum of three Medicare plans in Massachusetts.
- Enroll in Medicare online or by calling the Medicare Advantage plan carrier directly.
Local Medicare Advantage Resources
Age Strong
Seniors aged 55 and over who live in and around the city of Boston can receive help with managing their Medicare benefits from Age Strong, a program of the city government. Age Strong counselors and case workers are trained to educate seniors about various free and low-cost services they may be eligible for. The program offers referrals and direct assistance with discount and free prescription drug programs, and case workers can help eligible seniors sign up. Age Strong counselors are also able to help seniors find and apply for other, non-Medicare or Medicare Advantage programs.
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Massachusetts Medicare Part D
Original Medicare does not provide coverage for outpatient prescription drugs. More than half of Original Medicare beneficiaries nationwide have supplemental coverage via an employer-sponsored plan or Medicaid, and these plans often include prescription coverage.
But Medicare beneficiaries who do not have drug coverage through Medicaid or an employer-sponsored plan need Medicare Part D enrollment in order to have coverage for prescriptions. Medicare Part D plans can be purchased as a stand-alone plan, or obtained as part of a Medicare Advantage plan that has integrated Part D coverage. Medicare Part D was created under the Medicare Modernization Act of 2003, which was signed into law by President George W. Bush.
There are 27 stand-alone Medicare Part D plans for sale in Massachusetts for 2021, with premiums that range from about $7 to $135/month.
727,738 beneficiaries of Medicare in Massachusetts had stand-alone Part D coverage as of September 2020. Another 337,706 had Part D prescription coverage as part of their Medicare Advantage plans. Enrollment in Part D coverage is optional, but people who forego it without having creditable drug coverage from another source will end up paying a late enrollment penalty if they decide to sign up for Part D later in life.
Who Do You Call For Medicare Questions
allows you to execute any of the following:
- Check the status of a claim filed on your behalf
- Find out if a service or item will be covered by your Medicare insurance
- Ask a question about your balance or check on the status of a premium payment
- Learn which covered preventive exams you are eligible for
- Check on the balance of your Part A or Part B deductible or if a service or item will count toward your deductible
- Report possible Medicare fraud or a lost or stolen Medicare card
If you have questions about Medicare Supplement Insurance and how it can help pay for certain out-of-pocket Medicare costs , you can call a licensed insurance agent at .
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Apply For The Plan You Want
Now that you’ve picked your plan and understand what’s available in your area, there are a few ways to apply. If you already have a favorite insurance provider, you can go to their website or call them directly. Unfortunately, you cant compare prices from one provider to the next this waythe price the company quotes will be the price you pay.
If youd like to compare prices, you can also call one of our independent agents, who will be able to help you see prices from several insurance companies. Then once you’ve found the plan and price you like the best, they’ll walk you through the enrollment process, and you’ll be done!
Note: Interested in the most popular Medigap Plan, Plan F? Learn about changes to eligibility requirements for 2020 before going any further.
When Is My Medicare Initial Enrollment Period
For most people, enrolling in Medicare Part A is automatic. However, there are several instances where you may have to manually enroll in Medicare Part A and/or Part B during your Initial Enrollment Period , the seven-month period that begins three months before you turn 65, includes the month of your 65th birthday, and ends three months later.
Some situations where you would enroll in Medicare during your initial enrollment include:
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If You Have A Disability Esrd Or Als
Americans with a disability who have received Social Security disability benefits for 24 months are automatically enrolled in Medicare Part A and Part B. Automatic enrollment also applies to beneficiaries who have serious illnesses such as end-stage renal disease, ESRD, and amyotrophic lateral sclerosis, ALS. Youll receive your card when you qualify.
You dont need to do anything to sign up.
Similarly, if youve received disability benefits from the Railroad Retirement Board for 24 months, youll be enrolled automatically in Medicare Parts A and B.
Medicaid Eligibility In Massachusetts
Known as MassHealth, Massachusetts offers a Medicaid program to low-income individuals and families who need assistance with healthcare. The federal government partners with the state to ensure enough funding gets provided to those who truly need the insurance. Residents across Massachusetts facing financial difficulties can apply for state health insurance and see if they qualify. Certain stipulations exist for those hoping to get approved.
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Medigap Plan C And Plan F Changed In 2020
A slight but important change was made to the selection of standardized Medigap plans available in most states.
Plan C and Plan F are no longer available to new Medicare beneficiaries who became eligible for Medicare after January 1, 2020.
If you were already eligible for Medicare before January 1, 2020, you may still purchase Plan C or Plan F in 2020 and beyond if either plan is available where you live.
But anyone who became eligible for Medicare after January 1, 2020, will not be allowed to enroll in either of those two plans.
Anyone currently enrolled in Plan C or Plan F will be allowed to keep their plan going forward.
This 2020 Medigap plans change came as a result of federal legislation that prohibits full coverage for the Medicare Part B deductible. Plan C and Plan F are the only standardized Medigap plans that provide this benefit.
Ways To Apply For Disability Benefits:
- If you or your spouse worked for a railroad, call the Railroad Retirement Board at 1-877-772-5772.
Once your disability benefits start, well mail you a welcome package with your Medicare card.
Sign up for Part B if you live in Puerto Rico or outside the U.S.You get Part A automatically. If you want Part B, you need to sign up for it. If you dont sign up for Part B within 3 months after your Part A starts, you might have to wait to sign up for Part B and pay a monthly late enrollment penalty.
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Things You Should Know
How to find out whether or not you are eligible for Medicare Part A and Part B benefits if you are retired and under age 65 and your spouse or you are disabled
If you or your spouse is disabled and receiving Social Security disability benefits, contact Social Security about Medicare-eligibility. If eligible, contact the GIC at 617.727.2310 to request a Medicare Plan enrollment form.
If you have been a state employee and have never contributed to Social Security
You may still be eligible for Medicare benefits through your spouse. When you turn age 65, visit Social Securitys website or call Social Security to apply to see if you are eligible.
What happens to your spouse’s coverage if you enroll in a GIC Medicare Supplemental Plan
Your spouse will continue to be covered under in a GIC non-Medicare plan if he/she is under age 65 until he or she becomes eligible for Medicare. See the Benefit Decision Guide for under and over age 65 health insurance products. If your spouse is over age 65, he/she must enroll in the same Medicare supplemental plan that you have joined.
What you need to do at age 65 if your spouse or yourself was not eligible for Medicare Part A for free, but now, you and your spouse have subsequently become eligible for Medicare Part A for free
You or your spouse must notify the GIC in writing when you become eligible for Medicare Part A. The GIC will notify you of your coverage options. Failure to do this may result in loss of GIC coverage.
Already Enrolled In Medicare
If you have Medicare, you can get information and services online. Find out how to .
If you are enrolled in Medicare Part A and you want to enroll in Part B, please complete form CMS-40B, Application for Enrollment in Medicare Part B . If you are applying for Medicare Part B due to a loss of employment or group health coverage, you will also need to complete form CMS-L564, Request for Employment Information.
You can use one of the following options to submit your enrollment request under the Special Enrollment Period:
Note: When completing the forms CMS-40B and CMS-L564
- State I want Part B coverage to begin in the remarks section of the CMS-40B form or online application.
- If possible, your employer should complete Section B.
- If your employer is unable to complete Section B, please complete that portion as best as you can on behalf of your employer without your employers signature and submit one of the following forms of secondary evidence:
- Income tax form that shows health insurance premiums paid.
- W-2s reflecting pre-tax medical contributions.
- Pay stubs that reflect health insurance premium deductions.
- Health insurance cards with a policy effective date.
- Explanations of benefits paid by the GHP or LGHP.
- Statements or receipts that reflect payment of health insurance premiums.
Some people with limited resources and income may also be able to get .
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