1 min read
16 Feb

Yikes... Did you know that part D as in DRUGS is actually optional. Well, let's say optional to a degree. Completely optional but not necessarily without prior motivation???? CMS requires that you maintain CREDITABLE coverage as good as part d for every second that you don't have a part d plan while you're eligible for it. Sounds scary, but it's not that bad. Every month that someone does not have CREDITABLE coverage, they are subject to a one percent penalty when they enroll in the future, or if they ever buy an mapd (advantage plan with drug coverage). If you couldn't tell from my first video... I learned how to speak English in Tennessee. Ok back to the D word... 

More importantly here are 3 ways to avoid the penalty of 1% per month that you don’t have coverage of the national average premium $33.37 

1. Get one when you are first eligible. Remember you can “date” your drug plan… you don’t have to marry them. Every year you will be allowed to make changes for the next January 1 between October 15- December 7. 

2. Enroll if you receive notice that your coverage is not creditable or that you lose coverage. If you go 63 days between getting covered you will have to pay the penalty and wait to enroll. 

3. Keep proofs of creditable coverage. You don’t have to send the letters an employer or employee union sends to Medicare, but you should hang on to them for when you make the leap to Medicare or when your circumstance changes. Keep a paper trail to avoid these penalties. Notice of creditable coverage is sent in September from employer or employee union groups if your coverage is creditable. 

Like any penalty that Medicare gives, these charges are permanent and even apply if someone buys an advantage plan after not being covered. Lee in mind that since the national premiums may go up your penalty could go up also over time. 

What should you do if you don’t have any prescription medication at all? It’s up to you. You have the right to buy a plan or not as long as you are ok with future penalties. Sometimes it makes sense to get the least expensive plan that is also preferred at the pharmacy you prefer when you have occasional prescriptions. What if you get a crazy prescription in the middle of the year? If your pharmacy cannot fill a prescription, they should receive a notice that gives you contact information for your specific plan. If they don’t show this automatically, ASK FOR IT. When you receive that you can file an appeal. Here is a detailed step by step instruction of that process: 


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