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Home > SHIC > Medicare Part D
Medicare Part D
Medicare Part D is a voluntary prescription drug benefit and is offered by private companies that are approved by Medicare. The Medicare Part D annual enrollment period is Oct. 15-Dec. 7. The North Dakota Insurance Department encourages you to compare your plan annually during this time.

What you need to do a Part D plan comparison?
  • A list of your medications, including dosages and frequency
  • Your Medicare card
  • The full name of your current plan
  • If you are attending an enrollment event and have a yellow retrieval card from the North Dakota Insurance Department, bring it along to expedite assistance
How to compare your Part D plan:
  • Visit Medicare.gov and enter your information in the Plan Finder
  • Attend one of our free enrollment events
  • Call 2-1-1 from anywhere in North Dakota Oct. through Nov. 16, 2018 - after providing your medication information and answering some questions, information on the top three plans will be mailed to you

What is Part D?
Medicare Part D is a voluntary prescription drug benefit and is offered by private companies that are approved by Medicare.

Will my prescriptions be covered?
Each Part D plan will list the prescriptions that are covered under the plan; this list is called a formulary. The simplest method of determining if your drugs are covered is by using the planfinder on Medicare's website or by contacting the State Health Insurance Counseling Program (SHIC) at (888) 575-6611 for a comparison.

Can the formularies on Part D plans change?
The formularies, which are lists of the prescription drugs covered, can change. The companies must give the beneficiaries at least 60 days notice of change.

What is the Part D donut hole or coverage gap?
Medicare drug plans may have a coverage gap which is sometimes called the "donut hole." A coverage gap means that after you have spent a certain amount of money for covered drugs; the beneficiary will have to pay all the costs for the drugs while in the gap. This amount does not include the plan's monthly premium. Once the beneficiary has reached the out-of-pocket limit, then catastrophic coverage begins.

When can people sign up for a Part D plan?
Beneficiaries should sign up for a plan three months prior, the month of or three months after their 65th birthday. If a person continues to work after age 65 and has creditable coverage, they may not have to take a Part D plan until retirement.

If you receive Medicare due to a disability, you can join from three months before to three months after your 25th month of disability payments.

A delay in signing up may cause a penalty.

Each year, during the annual enrollment period from Oct.15-Dec. 7, beneficiaries can change plans. It is important to review Part D plans annually to make sure beneficiaries are enrolled in the most appropriate plan.

What is the process for enrolling in a Part D plan?
1. Compare a plan:

• Contact SHIC at (888) 575-6611 for a free drug plan comparison
• Visit Medicare's website to do one yourself or call (800) MEDICARE.

2. Select a plan - things to ask yourself:

• Does my pharmacy accept this prescription drug plan? Call your pharmacist to verify.
• Does the plan that is the best for me fit into my budget?
• Are all my medications covered by the plans?
• Does the plan have quantity limits or step therapy for any of my medications?

3. Enroll in a plan:

• Call (800) 633-4227 or (800) MEDICARE.
• Call the prescription drug plan.
• Contact a life/health agent who sells the plan.
• Contact SHIC at (888) 575-6611.

4. Utilize the plan:

• The Medicare PDP usually becomes effective the month after you apply.
• A plan membership card will be sent to you from the drug plan. Show this to the pharmacist when you purchase a prescription.
• Each year, everyone in a prescription drug plan should have a plan comparison completed between Oct. 15-Dec. 7, the annual enrollment period. The new plan will take effect Jan. 1 of the following year.

Do Medicare Advantage Plans offer drug coverage?
In certain Medicare Advantage plans, prescription drugs are covered. However, remember that these MA plans are not appropriate for everyone.

What are the Extra Help/LIS income guidelines for 2018?
A Social Security program called Low-income Subsidy (LIS) may help pay your Medicare premiums and drug costs.

How do I apply for LIS?
Contact the Social Security Administration at (800) 772-1213 or SHIC at (888) 575-6611 to apply for low income subsidy.

Four Easy Steps to Compare and Enroll in a Medicare Part D Drug Plan file size: 171 kb

North Dakota Insurance Department
600 E. Boulevard Ave.
Bismarck, ND 58505-0320
Phone 701.328.2440
Toll free 800.247.0560
Fax 701.328.4880

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