Last Updated on
October 6, 2016
Searching for Medicare Part D Prescription Drug Plans in Kansas? Let PlanPrescriber be your resource for Kansas Medicare Part D information and plan comparisons.
In the state of Kansas, Medicare beneficiaries can receive Medicare prescription drug coverage through two options, including enrollment in a stand-alone Medicare Part D Prescription Drug Plan and Medicare Advantage Prescription Drug Plan. Medicare Prescription Drug Plans, also known as PDP and Medicare Advantage Prescription Drug Plans, also known as MAPD are plans offered by private insurance companies contracted with Medicare to provide coverage on eligible medication costs to Medicare beneficiaries of Kansas and across the nation.
Kansas Medicare beneficiaries can sign up for a Medicare Part D Prescription Drug Plan to go alongside their Original Medicare coverage, Medicare Supplement (Medigap)plan, or certain types of Medicare Advantage plans that offer only health coverage.
Prescription drug coverage to help pay the cost of medications is a significant concern to many individuals. If you are a Medicare beneficiary who is concerned and interested in having prescription drug coverage, you will be interested in knowing how and when you can enroll in a Medicare plan that provides prescription drug coverage in Kansas.
To be eligible to enroll in a stand-alone Medicare Prescription Drug Plan, you must be enrolled in or eligible to enroll in Medicare Part A (hospital insurance) and Part B (medical insurance). Medicare Prescription Drug Plans are only available to Medicare beneficiaries. In addition, you must live within the service area of the Medicare Prescription Drug Plan you choose.
Alternatively you may choose a Medicare Advantage Prescription Drug plan where you reside in Kansas. Like stand-alone Medicare Prescription Drug Plans, a Medicare Advantage Prescription Drug plan is offered by private insurance companies who are contracted with Medicare. Unlike Medicare Prescription Drugs Plans, the Medicare Advantage Prescription Drug plan cannot stand alone. Medicare Advantage Prescription Drug plans combine Medicare health and prescription drug coverage into a single plan. The prescription drug coverage cannot be excluded from the health benefits offered by a Medicare plan of this type. Because Medicare Advantage plans are an alternative way for Medicare beneficiaries to receive Medicare Part A and Part B benefits, you must have Medicare Part A and Part B to enroll in a Medicare Advantage Prescription Drug plan. You must also reside in the plan’s service area, and you cannot be enrolled in a stand-alone Medicare Prescription Drug Plan at the same time.
If you’re signing up with a Medicare plan that offers Part D prescription drug coverage for the first time, you may do so in one of three different enrollment periods, depending on your circumstances:
Initial Enrollment Period (IEP): If you don’t yet have Medicare and have no other drug coverage that’s “creditable” (considered as good as Medicare’s), you can enroll in a Medicare Prescription Drug Plan at any time during your seven-month initial Medicare enrollment period. This lasts from three months before you turn 65, includes your birth month and three months after that. If you are under the age of 65 and are disabled you are eligible after your 25th month of receiving disability payments.
Special Enrollment Period (SEP): You’re entitled to an SEP in certain circumstances — for example, if you lose creditable drug coverage (such as from an employer or union sponsored plan). You also get a SEP to switch to another plan if you’re already enrolled in a Medicare Prescription Drug Plan, in certain situations—for example, if you move outside your plan’s service area; or you move into or out of a nursing home.
Annual Election Period (AEP): If you miss your deadline for joining Part D during an Initial Enrollment Period or an IEP or an SEP, then you cannot enroll in a Medicare Prescription Drug Plan until the next AEP. This enrollment period runs from October 15 to December 7 each year, with coverage beginning January 1. You also have to wait for an AEP if you deliberately drop creditable drug coverage that you already have (for example, from an employer or union).
The AEP also serves as an annual opportunity for anybody already enrolled in a stand-alone Medicare Prescription Drug Plan, a Medicare Advantage plan or a Medicare Advantage Prescription Drug plan to switch from one plan to another for the upcoming year. In addition, if you sign up for a Medicare Advantage Prescription Drug plan and decide to switch back to Original Medicare Part A and Part B, you can do so during the annual Medicare Disenrollment Period, which occurs between January 1 and February 14. You can enroll in a stand-alone Medicare Prescription Drug Plan on or before February 14. There are two important points about Medicare prescription drug coverage eligibility and enrollment you’ll want to keep in mind. First, you may be subject to a late enrollment penalty if you don’t have creditable prescription drug coverage (coverage at least as good as Medicare Part D) for 63 consecutive days or more following the end of your Initial Enrollment Period. The late enrollment penalty may continue for as long as you have Medicare prescription drug coverage. Therefore, it may be a good idea to enroll in a Medicare Prescription Drug Plan when you become eligible for Medicare Part A and Part B. Second, you continue to pay your Medicare B premium so that you do not lose your Medicare health benefits regardless of whether you enroll in a Medicare plan that includes prescription drug coverage or not.
The Kansas Medicare Rx Extra Help program is available to assist Medicare beneficiaries with lower incomes in paying their monthly premium and deductible for Medicare prescription drug coverage. This program may also provide subsidies to lower prescription drug co-payments for those who are eligible. For additional information, contact the Senior Health Insurance Counseling For Kansas (SHICK) program. You may also apply for Extra Help by visiting your local Social Security office or visit the Social Security https://www.ssa.gov/pubs/EN-05-10525.pdf website and apply online.
Each stand-alone Medicare Part D Prescription Drug Plan and Medicare Advantage Prescription Drug plan in Kansas has a formulary, which is a list of covered drugs. Often the formulary includes commonly prescribed brand-name medications and their generic equivalents. The formulary may change at any time. If enrolled, you will receive notice from your plan when necessary. Typically a Medicare Part D Prescription Drug Plan groups the medications in its formulary into coverage categories called “tiers.” Each tier has a designated out-of-pocket cost (e.g., copayment or coinsurance amount) for the medications within the tier. Typically different copayment or coinsurance amounts are assigned to each tier, based upon the relative cost of the prescription drugs.
Whether you are interested in a stand-alone Medicare Part D Prescription Drug Plan or a Medicare Advantage Prescription Drug plan, it is important to compare the plans that are available where you live in Kansas before you enroll. While many Medicare plans offering prescription drug coverage may be available in Kansas, not all may be available where you live. Also, plans offering Medicare Part D prescription coverage have different costs. Premiums, deductibles, copayments, and coinsurance are likely to vary. Formularies, the lists of covered prescription drugs, may vary by plan as well. So it’s important to check to see if your medications are on the plan’s formulary and, if so, on which tier.
If you are currently enrolled in a stand-alone Medicare Part D Prescription Drug Plan or a Medicare Advantage Prescription Drug plan, you will want to review your coverage on a yearly basis to be aware of any changes. Medicare plans offering prescription drug coverage in Kansas and the rest of the United States are allowed to change their premiums, copayments, deductibles, and formularies each year. You will receive notice of these changes in the Annual Notice of Change and Evidence of Coverage the plan mails you in the fall before the new benefits are effective the following January 1st.
To start comparing Medicare Part D Prescription Drug Plans in Kansas today, enter your zip code above for a customized list of plans available in your area. You can also enter in the medications you take to further tailor your plan listings and estimated costs.
Learn more about how Medicare plans work in Kansas, including: