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Medicare Part D Prescription Drug Plans in New Hampshire


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About Medicare Part D in New Hampshire

Medicare Part D coverage in New Hampshire is available for Medicare beneficiaries who wish to get help paying for prescription drug costs. You have a couple ways to get this coverage, depending on whether you’re enrolled in Original Medicare (Part A and Part B) or a Medicare Advantage plan.

Original Medicare only covers prescription medications in certain limited situations. Medicare Part A covers medications you get during a covered inpatient hospital stay, and Part B covers certain medications you get in an outpatient setting, like a doctor’s office. The medications covered by Medicare Part B tend to be prescription drugs you can’t give yourself, like vaccines or drugs given by infusion. For coverage of most other types of prescription drugs, you’ll need to sign up for Medicare Part D.

Original Medicare beneficiaries in New Hampshire, like the rest of the country, can get Medicare Part D benefits through a stand-alone Medicare Prescription Drug Plan. These plans are available through private insurance companies that are approved by Medicare to provide Medicare Part D coverage.

Another option is to get your Medicare Part D coverage through a Medicare Advantage Prescription Drug (MAPD) plan, which combines health insurance and drug coverage into one comprehensive plan. Medicare Advantage plans, also known as Medicare Part C, are an alternative way to get your Medicare Part A and Part B benefits, and these plans are required to cover at least the same level of benefits as Original Medicare. However, many Medicare Advantage plans also include additional benefits, which may include wellness programs, hearing, routine vision and dental, or prescription drugs. If you want prescription drug coverage and have Medicare Part C, you should get this coverage through a Medicare Advantage Prescription Drug plan, not a stand-alone Medicare Prescription Drug Plan.

Enrolling in Medicare Part D coverage in New Hampshire

Medicare Part D, like other parts of Medicare, has certain rules when it comes to eligibility and when you can enroll. New Hampshire beneficiaries, like the rest of the country, are eligible for Medicare Part D once they:

  • Have Medicare Part A and/or Part B, and
  • Live in the service area of a Medicare Prescription Drug Plan or Medicare Advantage Prescription Drug plan.

You can enroll in Medicare Part D during the following periods:

  • Initial Enrollment Period (IEP) for Part D: This is the time when you’re first eligible to sign up for Part D. For most people, this period coincides with their seven-month Initial Enrollment Period for Part B and starts three months before their 65th birthday, includes their birthday month, and ends three months later. For those who get Medicare because of disability, this period starts three months before the 25th month of disability benefits from Social Security or the Railroad Retirement Board and lasts seven months.
  • Annual Election Period (October 15 to December 7): After your IEP for Part D ends, this is your next chance to make changes. During this time, you can enroll in a Medicare Prescription Drug Plan or Medicare Advantage Prescription Drug plan for the first time, change Medicare plans, or disenroll from a plan.
  • Medicare Advantage Disenrollment Period (January 1 to February 14): If you change your mind and want to go back to Original Medicare, you can use this period to disenroll from your Medicare Advantage plan. In addition, regardless of whether your Medicare Advantage plan included prescription drug coverage, you can also use this time to enroll in a Medicare Prescription Drug Plan. These are the only two changes you can make during this period.
  • Special Election Period: Outside of the above periods, you can only make changes to your Medicare Part D coverage if you qualify for a Special Election Period. Some examples of situations that may qualify you include (but aren’t limited to) moving into a nursing home, moving out of your Medicare plan’s service area, or losing your Medicaid eligibility.

Comparing Medicare Part D coverage in New Hampshire

As noted above, Original Medicare does not cover prescription medication except in limited cases. If you’re enrolled in Original Medicare in New Hampshire and want additional coverage, a Medicare Prescription Drug Plan can help cover the costs of eligible brand-name and generic prescription medications. Or, if you prefer the convenience of having all of your coverage under one plan, you may want to consider enrolling in a Medicare Advantage Prescription Drug plan instead.

Remember, even if you aren’t currently taking prescription drugs, it’s important to get Medicare Part D as soon as you’re eligible, especially if you don’t have other insurance. If you don’t have Medicare Part D and go without other creditable prescription drug coverage (insurance that is as good as the standard Part D benefit) for 63 consecutive days or more, you could face a late-enrollment penalty if you enroll in Part D later on.

It is important to compare all available Medicare Part D coverage options in your area, since availability and costs will vary depending on your county of residence. Each private, Medicare-approved insurance company offering Medicare Part D coverage determines its own plan premiums, the prescription drugs that they will cover, and under which tier level those medications fall under (which affects your copayment and coinsurance costs). You may find that a prescription medication covered in a plan in one county is not covered in another county. Before enrolling in any Medicare plan that covers prescription drugs, you should check that your medications are included in the plan’s formulary, or list of covered drugs.

Keep in mind that the formulary may change at any time. You will receive notice from your plan when necessary. Because of this, it’s a good idea to review your Medicare plan’s Annual Notice of Change and Evidence of Coverage documents every year; these are materials your Medicare plan sends you in the fall to notify you of formulary or coverage changes that may affect you in the coming year. If you learn that your Medicare plan will no longer be covering a prescription medication you need or is significantly increasing the cost for certain prescriptions you take, you can then take advantage of the Annual Election Period that fall to find other Medicare plan options.

Need help finding Medicare Part D solutions that may fit your prescription drug needs? Just contact eHealth to get personalized assistance with a licensed insurance agent.

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