Last Updated on
October 6, 2016
As a Medicare beneficiary in Mississippi, you may want to consider enrolling in Medicare Part D to receive prescription drug coverage. In Mississippi, like in the rest of the United States, Medicare Part D is government-sponsored private insurance designed to help Medicare beneficiaries pay for their prescription drugs. Costs for stand-alone Medicare Part D Prescriptions Drug Plans in Mississippi vary depending on your particular location and zip code, but most require payment of a monthly premium, annual deductible, and copayments or coinsurance. In addition, the beneficiary must reside in the service area of whichever stand-alone Medicare Part D Prescription Drug Plan he or she selects.
Medicare beneficiaries in Mississippi may want to think about enrolling in Medicare Part D to get help paying for their prescription drug expenses when they are receiving health coverage through Original Medicare, Part A and Part B.
Each Medicare plan that includes prescription drug coverage in Mississippi, like those in the rest of the United States, has its own formulary, which is a list of covered prescription drugs. The formulary separates prescription drugs into different categories called tiers, with each tier having different price points. (Please note that the formulary may change at any time; you will receive a notice when necessary.) The lowest tier lists the most affordable prescription drugs, while the highest tier includes the more expensive medications. You or your physician can ask your plan for a tiering exception if your physician determines that a prescription drug in a higher tier is medically necessary to treat your health condition instead of a similar prescription drug in a lower tier. A tiering exception allows you to get a lower copayment for your higher-tier prescription drug.
Most Medicare plans that include prescription drug coverage in Mississippi allow you to choose between brand-name prescription drugs and generic prescription drugs. Generic prescription drugs, as described by the Food and Drug Administration, use the same active ingredients as brand-name prescription drugs, at the same strength, dosage form, and with the same method of administration. In addition, generic prescription drugs are tested to have the same results as brand-name drugs. However, generic prescription drugs usually cost less than the brand-name versions, resulting in lower out-of-pocket expenses. In case your generic prescription drug is not available, your Medicare plan that includes prescription drug coverage may allow you to substitute it with a similar generic prescription drug, meaning that you wouldn’t have to pay for the more expensive brand-name prescription drug, so be sure to discuss all prescription drug options with your doctor or health-care provider.
You may enroll in a stand-alone Medicare Part D Prescription Drug Plan in Mississippi during your Medicare Initial Enrollment Period, which begins three months before you turn 65, includes your birth month, and ends three months after that month. If you’re enrolled in Medicare due to a disability, you can enroll in Medicare Part D in Mississippi from three months before until three months after your 25th month of disability. Remember that you must either have or be eligible to enroll in Medicare Part A to enroll in Medicare Part D in Mississippi.
You may also enroll in Medicare Part D in Mississippi during the annual Open Enrollment Period for Medicare Advantage and Medicare prescription drug coverage, which runs from October 15 to December 7. And you can switch from one stand-alone Medicare Part D Prescription Drug Plan to another during the same period.
Another time you can join a stand-alone Medicare Part D Drug Plan is during the Medicare Advantage Disenrollment Period, which runs from January 1 to February 14 each year. If you disenroll from Medicare Advantage during this period and return to Original Medicare, Part A and Part B, you can add a stand-alone Medicare Part D Prescription Drug Plan through February 14 as well.
Always remember that if you go without creditable prescription drug coverage for 63 days or more after your Initial Enrollment Period ends, you may have to pay a late-enrollment penalty for Medicare Part D in Mississippi, just like you would in the rest of the United States. The penalty is calculated using 1% of the national base beneficiary premium and the number of full months you were eligible for Medicare Part D but didn’t join. This amount is then added to your Medicare Part D monthly premium. The national base beneficiary premium may increase each year, which means your late-enrollment penalty may also increase annually.
It’s important for you to understand that even if you join a stand-alone Medicare Part D Prescription Drug Plan, you have to remain enrolled in Medicare Part A, and pay any Part A premiums (if you’re not entitled to premium-free Medicare Part A coverage), to retain your health coverage.
There are two ways to receive prescription drug coverage in Mississippi: 1) through a stand-alone Medicare Part D Prescription Drug Plan (if you remain with Original Medicare), or 2) through a Medicare Advantage Prescription Drug Plan. A stand-alone Medicare Part D Prescription Drug Plan refers to a plan that Medicare beneficiaries may enroll in addition to Original Medicare, Part A and Part B, to help cover costs for prescription drugs.
A Medicare Advantage Prescription Drug plan (which is different from a stand-alone Medicare Part D Prescription Drug Plan) combines health and prescription drug coverage into a single plan, offering at least the same coverage as Original Medicare, and in certain cases additional benefits like vision, hearing, and dental, all for a single premium. The exception is hospice care, which Medicare Part A still provides. Medicare Advantage is an alternative way to receive your Original Medicare benefits.
When comparing stand-alone Medicare Part D Prescription Drug Plans in Mississippi, it’s smart to take into consideration your personal prescription drug requirements, since it’s your prescription drug cost––more so than your premiums or deductibles––that usually determines most of your out-of-pocket expenses.
It’s also a good idea to review your Medicare plan that includes prescription drug coverage at the end of every year to be aware of any changes to your coverage. Medicare plans that include prescription drug coverage in Mississippi may change their premiums, copayments, deductibles, and prescription drug formularies on an annual basis, which means that your current plan may not fit your prescription drug needs in the coming year. You may even want to shop for a new plan every year during the Annual Election Period.
To get more details about Medicare in Mississippi, see the following pages: