If you have prescription drug coverage through a private insurance company, or an employer/retiree plan, or VA, or a union plan, or a supplemental (Medigap) policy, you may not need Part D coverage. You should have received a letter, or a newsletter, or other information from your insurance provider stating whether your prescription drug coverage qualifies as “creditable coverage.” If you have not received a letter describing whether your prescription drug coverage qualifies as “creditable coverage,” contact your insurance plan Administrator or Human Resources department.There are several ways to enroll in Part D coverage:
- Visit the official Medicare enrollment site on the web and enroll on-line in a Part D Plan. For information about which Part D plan will best meet your prescription needs, go to Medicare's Formulary Finder on the web.
- If you have Medicaid (MaineCare), or Low Cost Drugs for the Elderly and Disabled (DEL), call: MaineCare Pharmacy Help Desk at 1-866-796-2463, or TTY: (800) 423-4331 (for the hearing impaired)
- If you have prescription drug coverage through a private insurance company, or an employer/retiree plan, or VA coverage, or a union plan, or a supplemental (Medigap) policy, call: Your plan administrator or your Human Resource Department.
- If you are unsure about your current prescription drug coverage, or if you need assistance with enrolling, call: Maine State Health Insurance Assistance Program (SHIP) at 1-877-353-3771, or TTY: 1-800-750-5353 (for the hearing impaired)
- The Monthly Premium is the amount you pay each month to the Part D plan for coverage. Each Part D plan has a different Monthly Premium.
- The Yearly Deductible is the amount you pay before your coverage begins. (Some Plans have a $0 deductible.) This Deductible is in addition to your Monthly Premium. During the Deductible you pay 100 percent of your drug costs.
- A Co-payment (or Co-Insurance) is the amount you pay for your prescriptions after you have met the Yearly Deductible amount. This will vary depending on your total drug costs and the particular Part D Plan you are in.
Most Part D Plans currently have a Coverage Gap (the "Donut Hole"), but under Health Care reform, the Coverage Gap will gradually go away. In 2012, while in the Coverage Gap, you will pay 50 percent of the cost of your brand-name drugs and about 86 percent of the cost of your generics (instead of 100 percent of the cost for both). In 2012 you will enter the Coverage Gap once the total cost of your drugs reaches $2,930. (Total cost means the amount you paid for your drugs combined with the amount the Part D Plan paid for them.) In 2012, you will get out of the Coverage Gap for the rest of the Plan year after you spend $4,700 out-of-pocket on your Part D drugs (That amount does not include the cost of your premiums.).
Once you are out of the coverage gap, you will pay a small co-insurance/co-payment for your drugs for the rest of the Plan year.
The list below contains the highest rated Medicare Part D prescription drug plans in the state of Maine. 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.