Prescription drug costs are expensive, so you likely want some sort of coverage to go with your Medicare plan. Medicare Part D coverage is available to Illinois residents who want to have prescription drug benefits when using Original Medicare (Part A and Part B). You also have the option of adding prescription drug coverage to a Medicare Advantage (Part C) plan. Before getting Medicare Part D coverage in Illinois, get the details.
If you add Medicare Part D to Original Medicare, it will be a standalone policy. Your Original Medicare plan will cover your healthcare costs, while Medicare Part D will cover your prescription costs.
If you have a Medicare Advantage plan, your prescription coverage will work differently. First, it’s important to understand that some Medicare Advantage plans do not include prescription coverage. These plans are required to have at least the same coverage as Original Medicare, so insurance companies don’t have to include prescription drug coverage. To get prescription drug coverage, you need to select a Medicare Advantage Prescription Drug plan. Check for additional benefits when you find the plan. Many of these policies cover dental, vision, and more.
Second, instead of acting as a standalone policy, the prescription drug coverage will be bundled with your health insurance policy. That means you will have a single plan instead of two separate ones.
Medicare Part D coverage is available if you have Medicare Part A and/or Part B and live in a service area where plans are available. You need to enroll in Medicare Part D coverage during an enrollment period. There are four enrollment periods throughout the year. You can add Medicare Part D coverage in Illinois during any of these enrollment periods.
First, you can enroll in coverage during the Initial Enrollment Period. This period begins three months before the month you turn 65 and ends three months after your birthday month.
Your Initial Enrollment Period will be different if you receive Medicare because of a disability. The period begins three months before the 25th month of benefits and ends three months after the 25th month of benefits.
There is an Annual Election Period each year from Oct. 15 to Dec. 7. During this time, you can change your current Medicare plan and sign up for Medicare Part D coverage in Illinois.
If you have a Medicare Advantage plan and want Original Medicare instead, you can make the switch during the disenrollment period. The period runs from Jan. 1 to Feb. 14. After you switch to Original Medicare, you can add Medicare Part D coverage.
You can also add prescription coverage during a Special Election Period if you meet the criteria. If you have lost Medicare coverage because your plan is no longer offered in your service area, you move to a location where your plan doesn’t apply, or you relocated to the United States after living abroad, you can get Medicare coverage, including Medicare Part D, during the Special Election Period.
Once you are eligible for Medicare, you need to have Medicare Part D or creditable prescription coverage to avoid paying a penalty. If you don’t have Medicare Part D or creditable prescription overage for 63 days or longer after the open enrollment period, you will be assessed a penalty if you add the coverage at a later date.
The government calculates the penalty by taking the number of months you went without creditable prescription coverage and multiplying it by 1 percent of the national base beneficiary premium (it’s $33.19 in 2019). The amount you owe will be added onto your Medicare Part D monthly premium. In general, you’ll have to pay this penalty for as long as you have a Medicare drug plan.
Keep in mind that the national base beneficiary premium can increase each year. That means your penalty can go up, so it is critical to get coverage as soon as possible.
You know you need prescription drug coverage, but you aren’t sure which plan is right for you. Whether you need to add Medicare Part D to Original Medicare or need a prescription drug plan for Medicare Advantage, a licensed insurance agent can help. Get quotes and help selecting a plan by calling 844-903-4406. A licensed insurance agent will walk you through the entire process.