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Medicare Part D Plans in Rhode Island
About Medicare Part D coverage in Rhode Island
Medicare beneficiaries in Rhode Island have a couple options when it comes to Medicare prescription drug coverage, also known as Medicare Part D. How you get your Medicare Part D coverage will depend on whether you're currently enrolled in Original Medicare (Part A and Part B) or a Medicare Advantage plan.
Rhode Island beneficiaries with Original Medicare (Part A and Part B) are covered for certain hospital and medical benefits, but prescription drug coverage is limited. Original Medicare will cover certain prescription drugs you get in some situations, including a covered inpatient hospital or skilled nursing facility stay or in a doctor's office. However, for coverage of most other medications, you'll need to enroll in a stand-alone Medicare Prescription Drug Plan. These plans work alongside Original Medicare coverage to provide prescription drug benefits.
Another option is to enroll in a Medicare Advantage plan that includes this coverage. Also known as Medicare Advantage Prescription Drug plans, these plans cover Medicare Part A, Part B, and Part D benefits under a single plan. There's no need to enroll in a separate Medicare Prescription Drug Plan if you have a Medicare Advantage plan that includes prescription drug benefits.
Medicare Advantage plans are an alternative to Original Medicare and are required to cover at least the same level of coverage as Medicare Part A and Part B. However, many plans also include additional benefits not covered by Original Medicare, such as routine vision or dental, hearing, or prescription drugs.
Both Medicare Prescription Drug Plans and Medicare Advantage Prescription Drug plans are available through private insurance companies that are approved by Medicare.
Enrolling in Medicare Part D coverage in Rhode Island
In Rhode Island, as in the rest of the United States, you're first eligible for Medicare Part D if:
You have Medicare Part A and/or Part B, and
You live in the service area of a Medicare plan that includes prescription drug coverage.
Like other parts of Medicare, you can only enroll in or make changes to your Medicare Part D coverage during certain times. Those periods include:
Initial Enrollment Period (IEP) for Part D: This period coincides with when you're first eligible for Medicare and often overlaps with your Initial Enrollment Period for Part B. If you get Medicare because of age, this seven-month period takes place three months before your 65th birthday, includes the month you turn 65, and ends three months later. If you 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, then continues for seven months.
Annual Election Period (October 15 to December 7): If you missed your Initial Enrollment Period for Part D or want to make changes, you can do so every year during this time, also known as the Fall Open Enrollment. During this period, you can enroll in a Medicare Prescription Drug Plan or Medicare Advantage Prescription Drug plan for the first time. If you're already enrolled in a Medicare plan that includes prescription drug benefits, you can switch plans. You can also use this period to disenroll from your Medicare plan.
Medicare Advantage Disenrollment Period (January 1 to February 14): If you are enrolled in a Medicare Advantage plan but would like to return to Original Medicare, you can use this period to do so. Then, regardless of whether your Medicare Advantage plan included prescription drug coverage, you can also use this time to enroll in a stand-alone Medicare Prescription Drug Plan (since Original Medicare doesn't include Medicare Part D coverage).
Special Election Period: Special Election Periods can occur at any time that you have a qualifying situation. Some examples of events that may qualify include moving out of your Medicare plan's service area, qualifying for the Extra Help program, or having your Medicare plan's contract terminated by the Medicare program.
Comparing Medicare Part D coverage in Rhode Island
As you can see, Rhode Island beneficiaries have several choices when it comes to Medicare Part D and how to get that coverage. Even if you don't currently take prescription drugs, it may be a good idea to enroll in Medicare Part D to help protect against future needs. In addition, you could face a late-enrollment penalty later if you don't have Medicare Part D and go without other creditable prescription drug coverage (insurance that is as good as the Part D benefit) for 63 consecutive days or more.
As you research and compare Medicare plan options in your area, keep in mind that Medicare Prescription Drug Plans and Medicare Advantage Prescription Drug plans may vary when it comes to costs, benefits, and the medications they cover. To find out if a Medicare plan covers your specific prescription drugs, check the formulary, or list of medications covered by the plan. The formulary may change at any time. You will receive notice from your plan when necessary.
Also keep in mind that Medicare plans that include prescription drug coverage may vary when it comes to cost-sharing expenses, even when covering the exact same medications. Medicare Prescription Drug Plans and Medicare Advantage Prescription Drug plans typically place covered prescription drugs into cost "tiers," and you'll have different copayments and coinsurance costs for the medications on each tier. Each Medicare plan that includes prescription drug coverage categorizes its medications into tiers differently, so shopping around can help you find coverage for your prescription drugs at the lowest cost.
Do you need help finding Medicare plan options that cover your prescription drugs and fit your budget? Simply give eHealth a call to speak with a licensed insurance agent and learn about coverage options that may work for you.