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Medicare Part D Basics

 

In December 2003, Congress passed the Medicare Modernization Act and created Medicare Part D. The Medicare Part D benefit took effect January 2006 and was created to help pay for prescription drugs for people who receive Medicare benefits.

 

Eligibility

 

In order to be eligible for Medicare Part D, you must be eligible for Medicare Part A and/or Medicare Part B. If you currently get your health care covered by Medicare, including those who have some Medicare costs paid through Medicaid, this prescription drug coverage will be a new benefit. If you currently have both Medicare and Medicaid, as of January 1, 2006, you will begin receiving your prescription drugs through Medicare only.

  • Medicare Part D Coverage & Benefits

    Medicare Part D Coverage & Benefits

    If you would like further detailed information regarding Medicare Part D coverage and benefits, please visit the Medicare website.

    Learn More
  • Cost-sharing for low-income beneficiaries

    Cost-sharing for low-income beneficiaries

    For information about cost-sharing for low-income beneficiaries, please visit the Centers for Medicare & Medicaid website.

    Learn More

To inquire about low income subsidy status or level, please call Social Security

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      Phone

      1 (800) 772-1213

30 Day Notice of Change

Important Coverage Changes to Certain Drugs on the Preferred Care Partners Formulary

Coverage for certain drugs on the Preferred Care Partners formulary (the list of covered drugs) will be changing. Please review the formulary changes listed in the formulary to determine whether they will affect any medications you are currently taking.


From time to time, Preferred Care Partners makes changes to its formulary. These changes may include removing drugs from the formulary, adding new coverage requirements, applying limits, or moving drugs to a higher cost-sharing tier. When we make any of these changes, we will notify you at least 30 days before the change becomes effective. However, if the FDA finds that a drug on the formulary is unsafe or if the drug's manufacturer removes the drug from the market, we immediately remove the drug from our formulary and then notify you of the change.


  • Ask your doctor if the formulary change affects how you use your medication. If it does, ask your doctor about your treatment options. In some cases, your doctor may be able to make a simple change in your prescription (such as changing the dose or quantity of medication that you take). In other cases, your doctor may feel that one of the alternative drugs listed in the table is appropriate for you.

  • If your doctor feels that changing your prescription is not right for your medical condition, you or your doctor may request an exception.