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Prescription Drug Plans

New Mexico Part D Medicare Plans & Prescription Drug Coverage

Medicare offers prescription drug coverage (Part D) for everyone with Medicare.

If a beneficiary is not new to Medicare, but wishes to enroll, he or she may enroll during the annual enrollment period (October 15 – December 7). At this time, individuals may also “switch” plans.

Any individual new to Medicare can enroll within three months prior to their 65th birth date, the month of their birth date, and three months following.

There may be a 1 percent per month late enrollment premium penalty fee.

It is important when selecting a Part D plan that you search the plan’s covered drug list to make sure your drugs are covered. Only drugs on the plan’s preferred drug list will be counted as a cost, both to meet the deductible and the coverage gap (also called the “donut hole”).

The coverage gap refers to the time when you have reached your drug plan’s limit on costs and after which you must pay out-of-pocket for your prescriptions up to a yearly limit. If you reach this coverage gap in 2011, you will get a 50% discount on covered brand-name drugs purchased for the remainder of that year. This discount should increase yearly through 2020, when the coverage gap should no longer exist.

Once you have reached the cap on the total drug costs for any year, you will only pay a small amount for your drugs for the rest of that year.

In 2012, if an individual is in a Medicare Part D Prescription Drug Plan (PDP) with the standard benefit, he or she will pay a deductible of $320 and 25 percent of allowable Part D prescription drug costs between $320 and $2,930 ($652.50). The individual then hits a coverage gap, where he or she is will get a 50% discount on covered brand-name prescription drugs and pay 86% of the plan’s cost for covered generic drugs until he or she reaches the out-of-pocket maximum of $4,700. After the individual incurs total drug costs of $6,657.50, he or she becomes eligible for catastrophic coverage, which generally covers 95 percent of prescription drug expenses. The chart below explains how the Medicare Part D standard benefit design will work in 2012.

New Mexico also offers a state-specific Discount Prescription Drug Program (DPDP). This program is administered through the New Mexico Retiree Health Care Authority and is a state-sponsored program available to all New Mexico residents, regardless of whether or not they have insurance. When you enroll, you receive a card and a list of over 300 pharmacies that participate in the program. Contact the website at www.nmrhca.state.nm.us/ or call (800) 233-2576 for more details.

The list below contains the highest rated Medicare Part D prescription drug plans in the state of New Mexico. 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.