Anyone who meets the following criteria is eligible for Medicare Prescription Drug coverage, and Blue MedicareRx membership:
- You are entitled to Medicare benefits under Part A or enrolled in Part B.
- Your permanent residence is within the Blue MedicareRx service area.
Are There Any Enrollment Restrictions?
Enrollment in Medicare Prescription Drug Coverage has the following restrictions:
- If you are entitled to Medicare Prescription Drug coverage due to enrollment in Part D, you should continue to pay your Medicare Part B premium, if not otherwise paid for under Medicaid or by another third-party, even if the Part D premium is $0.00.
- You can only enroll in only one Part D plan at a time.
- You cannot enroll in a Medicare Advantage (MA) plan unless it is a PFFS (Private Fee-For-Service) plan or Medicare Savings Account plan.
- You cannot enroll in a Medicare Advantage Plan with Part D (MA-PD) plan
- If you have a Medicare Supplement (Medigap) policy that includes prescription drug coverage, you must contact your Medigap Issuer to let them know that you have joined a Medicare Prescription Drug Plan. You may not have drug coverage under a Medigap plan and Part D.
When Should I Join?
- Open Enrollment Periods
Medicare's prescription drug program (Part D) has certain time periods when people can enroll, similar to Part A and Part B coverage. These are called enrollment periods, and there are serveral different types.
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People who are eligible for Medicare after January 31, 2006 will have the same Initial Enrollment Period for Medicare Part D as they do for Medicare Part B (the month of eligibility plus the three months before and three months after). After that time, individuals will have an opportunity to join a Prescription Drug Plan once a year, from November 15 through December 31 (Annual Coordinated Election Period).Delaying enrollment after the initial enrollment period may result in a late enrollment penalty.
- Special Election Period
A Special Election Period (SEP) is provided for certain situations, such as an individual making a permanent move outside the service area, the Medicare Prescription Drug plan organization breaks its contract with an individual or does not renew its contract with CMS (Centers for Medicare and Medicaid Services), or other exceptional conditions determined by CMS. During an SEP, an individual may discontinue enrollment and change to a different Medicare Prescription Drug Plan plan.
- Annual Coordinated Election Period
The Annual Coordinated Election Period (AEP) occurs November 15 through December 31 of every year. During the AEP individuals may enroll in and disenroll from a Medicare Prescription Drug Plan (PDP) plan, or choose another PDP plan.
What is the late enrollment penalty?
Enrollment in Medicare’s prescription drug coverage is your choice. If you already have prescription drug coverage and you are comfortable with those benefits, you may choose not to enroll in a Medicare Prescription Drug Plan. However, if you decide not to enroll in a Medicare Prescription Drug Plan at the first opportunity, you may be subject to a late enrollment penalty when you do enroll.
This penalty was designed to encourage people to sign up for coverage at the youngest possible age, which helps keep overall costs of the drug program more affordable, and is similar to the late enrollment penalty for Medicare Part B. The late penalty will be 1% of the premium amount. That percentage will accumulate each month enrollment is delayed.
In some instances, people may delay enrollment in Medicare’s prescription drug coverage without paying a penalty. For example, you may already have creditable coverage (a drug benefit of equal or greater value than Medicare standard prescription drug coverage) and choose not to enroll in a Medicare Prescription Drug Plan (PDP). No late penalty would apply in this instance.
For more information about Blue MedicareRx please click on the links below or contact us.
Blue MedicareRx Brochure
Enrollment Instructions
Print an Enrollment Form
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