Frequently Asked Questions

Medicare Part D became effective Jan. 1, 2006, as the result of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. Medicare Part D is a prescription drug benefit provided by private insurance companies and other providers approved by Medicare who contract with the federal government.

Q. Who qualifies for Part D prescription drug plans?
A. You can join a Part D prescription drug plan if you are entitled to Medicare Part A and/or enrolled in Medicare Part B and live in the plan's service area.

Q. When can I sign up?
A. Your participation in Part D is not automatic. The annual enrollment period (AEP) begins Oct. 15 and ends Dec. 7, with coverage taking effect Jan. 1 of the following year. Provided you maintain continuous coverage, individuals enrolled in Medicare Part D are allowed to switch plans every year between Oct. 15 and Dec. 7, to take effect Jan. 1 of the following year.

Q. What are the benefits of Part D & how much does it cost?
A.Whatever plan you choose, Medicare prescription drug coverage assists with your expenses for brand-name and generic drugs. Although Medicare pays a substantial portion of the cost, you must enroll in a Part D plan by paying a small monthly premium. Additionally, you may pay a deductible, depending on which plan you choose and in which state you live. You also are responsible for a copayment/coinsurance for your prescription drugs, which varies too, depending on which plan you choose and in which state you live.

Q. Do you offer reasonable copays on mail order prescriptions?
A.Yes! Our plans cover preferred generic drugs at a $0 copay if you purchase them through our convenient mail order. Our other copays are very competitive.

Q. Am I protected against increased drug costs?
A. Enrollment in Part D could buy you the protection you need if your drug costs become very high. Remember, using generics can help reduce prescription drug costs.

Q. Do I get a discount on prescription drugs?
A. You have access to discounted prices if you join our Medicare prescription drug plan and use our pharmacy network. Medicare Part D plans use various networks, so check to see if your pharmacy is in our network.

Q. Are the drugs I need covered by Medicare Part D?
A. Covered drugs can vary from plan to plan, so be sure to review each plan's formulary information, which is available at www.medicare.gov beginning in October. You may want to consider switching your prescription to an equivalent drug to ensure you are getting the best possible health care at the lowest cost.

Q. How do I know if I'm getting the best value?
A. Enrollees should be able to compare prices of the different Medicare Part D prescription drug plans on Medicare's website at www.medicare.gov.

Q. Will I pay more if I enroll late?
A. Medicare requires you to pay a late enrollment penalty if you don't join a Medicare prescription drug plan when you are first eligible to join or you have a break in coverage, and there is a period of 63 or more continuous days during which you don't have creditable prescription drug coverage as good as Medicare's prescription drug coverage.

Q. How can I be sure your plan offers pharmacies that are convenient and in my home town?
A. You can learn which pharmacies are in our network. Our plans offer the same cost sharing whether you use in-network or out-of-network pharmacies. If the 'in-network' pharmacies available in a plan are not local, you may find using a mail order pharmacy to obtain medications is the most cost-effective option. Of course, you may choose to eliminate local pharmacy fulfillment altogether and use the mail order pharmacy option, with $0 copays for Preferred Generics, as the most convenient and cost-effective method.

Q. Can I qualify for Extra Help?
A. People with limited incomes may qualify for Extra Help to pay for their prescription drug costs. If eligible, Medicare could pay for up to one-hundred (100) percent of drug costs including monthly prescription drug premiums, annual deductibles, and co-insurance. Additionally, those who qualify will not be subject to the coverage gap or a late enrollment penalty. Many people are eligible for these savings and don't know it. For more information about this Extra Help, contact your local Social Security office or call 1-800-MEDICARE (1-800-633-4227), 24 hours per day, 7 days per week. TTY users should call 1-877-486-2048.

Q. What should I know if I have prescription drug coverage from a former or current employer or union?
A. Medicare will help employers or unions continue to provide retiree drug coverage that meets Medicare's standards. You or your spouse's former or current employer or union will send you information about how your current coverage compares to the Medicare standard prescription drug coverage. This information is important because it can affect the decision you need to make this fall regarding if and when you sign up for Medicare prescription drug coverage.

If you or your spouse's employer or union determines your current coverage, on average, is at least as good as the Medicare standard prescription drug coverage (called creditable prescription drug coverage):

• •  You can keep it as long as it is still offered by your employer or union.
  
• •  You won't have to pay a penalty if your employer or union stops offering prescription drug
     coverage as long as you join a Medicare drug plan within 63 days after the coverage ends.

Caution: If you drop your employer or union coverage, you may not be able to get it back. You also may not be able to drop your employer or union drug coverage without also dropping your employer or union health coverage.

If your employer or union plan is not as good as Medicare prescription drug coverage, find out about your options from your Benefits Administrator. You may be able to:

• •  Keep your current employer or union drug plan and join a Medicare drug plan to give you
     more complete prescription drug coverage.
• •  Drop your current coverage and return to the original Medicare plan.
  
• •  Join a Medicare prescription drug plan.
  
• •  Join a Medicare Advantage plan or other Medicare health plan that covers prescription drugs.
     See the caution above.

Q. What should I know if I have drug coverage from TRICARE, the Department of Veteran's Affairs (VA), or the Federal Employee Health Benefits Program (FEHB)?
A. Contact your Benefits Administrator or FEHB insurer for information about your TRICARE, VA, or FEHB coverage before making any changes. It is almost always to your advantage to keep your current coverage without any changes. If you lose your TRICARE, VA, or FEHB coverage, in most cases you won't have to pay a penalty, as long as you join a Medicare drug plan within 63 days of losing TRICARE, VA, or FEHB coverage.

Q. How does healthcare reform affect Medicare Part D?
A. Healthcare reform law will reduce the amount Medicare Part D enrollees are required to pay for prescriptions when the coverage gap (donut hole) is reached. In 2012, Part D enrollees who reach the coverage gap will pay only 50% of brand drugs and pay only 86% of generic drugs. By 2020, it is expected that the government will increase various subsidies so that Part D enrollees will be responsible for only 25% of the total cost of their drugs out of pocket.
Sources:
Focus on Health Reform, The Kaiser Family Foundation, March 2010; Closing the Prescription Drug Coverage Gap, CMS, May 2010.

Q. How do I end my membership in your plan?
A. Usually, to end your membership in our Part D Plan, you simply enroll in another company's Medicare prescription drug plan during one of the enrollment periods. However, there are a couple of exceptions:

One exception is when you want to switch from our Plan to Original Medicare without a Medicare prescription drug plan. In this situation, you must contact Customer Service and ask to be disenrolled from our Plan. Contact Us

Another exception is if you join a Private Fee-For-Service plan without prescription drug coverage, a Medicare Medical Savings Account plan, or a Medicare Cost plan. In this case, you can enroll in that plan and keep our Plan for your drug coverage. If you do not want to keep our Plan, you can choose to enroll in another Medicare prescription drug plan or to drop your Medicare prescription drug coverage.

The information below further explains how you can end your membership in our Medicare Part D prescription drug plan.

If you would like to switch from your participation in one of our Plans to another United American Plan:
Click Here or Contact Us

If you would like to switch from one of our Plans to:

• •  Another Medicare prescription drug plan...or
  
• •  Enroll in the new Medicare prescription drug plan...

...You will automatically be disenrolled from our Plan when your new plan's coverage begins.

A Medicare Advantage plan
Enroll in the Medicare Advantage plan. With most Medicare Advantage plans, you will automatically be disenrolled from our Plan when your new plan's coverage begins. However, if you choose a Private Fee-For-Service plan without Part D drug coverage, a Medicare Medical Savings Account plan, or a Medicare Cost plan, you can enroll in that new plan and keep our Plan for your drug coverage. If you want to leave our Plan, you must either enroll in another Medicare prescription drug plan or contact our Company's Customer Service Department, or Medicare, and ask to be disenrolled. Contact Us
Or, contact Medicare and ask to be disenrolled: 1-800-MEDICARE (1-800-633-4227). TTY users: 1-877-486-2048.

Original Medicare without a separate Medicare Prescription Drug Plan
Contact Customer Service and ask to be disenrolled from the Plan. Contact Us
Or, contact Medicare and ask to be disenrolled: 1-800-MEDICARE (1-800-633-4227). TTY users: 1-877-486-2048.

Updated 10/01/11