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Prescription Drug Plans

Maryland Part D Medicare Plans & Prescription Drug Coverage

The decisions you make about which Part D/prescription drug plan you choose, if any, are going to be very specific to you and your needs. If you decide not to join a Medicare drug plan when you are first eligible, and you don’t have other creditable prescription drug coverage, you will likely pay a late enrollment penalty should you decide to join at a later date.

You can join, switch, or drop a Medicare Part D drug plan between October 15 and December 7 in 2011. Coverage begins on January 1, 2012, as long as your plan gets your enrollment request by December 7.

A late enrollment penalty is added to your Part D premium if you did not join a Medicare drug plan when you were first eligible for Medicare and you did not have other creditable prescription drug coverage; or if you did not have Medicare prescription drug coverage or other creditable prescription drug coverage for 63 days or more in a row. (Note that those who qualify for Extra Help do not pay late enrollment penalty.)

If you don’t agree with your penalty, you may be able to ask Medicare for a review or reconsideration. You will need to fill out a reconsideration request form, available from your Medicare drug plan, to provide proof that supports your case such as information about previous drug coverage.

Like any other prescription drug plan, there is a monthly premium, a yearly deductible and co-payments for part of the cost of prescriptions. Actual drug plan costs will vary depending on the prescriptions you use, the plan you choose, whether the pharmacy you use is in the plan’s network and whether your drugs are on your plan’s formulary (drug list).

Most Medicare drug plans have a “coverage gap” (also known as the “donut hole”). This means that after you and your Medicare drug plan have spent a certain amount of money for your covered drugs, you have to pay all costs out-of-pocket for your prescriptions up to a yearly limit. You must also continue to pay the plan’s monthly premium even while you are in the coverage gap. Not everyone will reach the coverage gap.

Once you reach your plan’s out-of-pocket limit (no more than $4,550 in out-of-pocket drug costs during 2011), you automatically get “catastrophic coverage.” Catastrophic coverage ensures that once you have spent up to your plan’s out-of-pocket limit for covered drugs, you only pay a small coinsurance amount or copayment for the drug for the rest of the year.

The list below contains the highest rated Medicare Part D prescription drug plans in the state of Maryland. It is for informational purposes only and some listings may be inaccurate or missing. The list was provided by the Centers for Medicare and Medicaid Services (CMS), but due to the variance in plans based on county, city, and region, some options may not be available in your location.