What are two options for Medicare consumers to get Part D prescription drug coverage quizlet?
Asked by: Esteban Kertzmann DVM | Last update: October 9, 2025Score: 4.6/5 (61 votes)
What are two options for Medicare consumers to get Part D?
A program that helps pay for prescription drugs for people with Medicare who join a plan that includes Medicare prescription drug coverage. There are two ways to get Medicare prescription drug coverage: through a Medicare Prescription Drug Plan or a Medicare Advantage Plan that includes drug coverage.
How does one become eligible for Part D prescription drug coverage Quizlet?
To be eligible for Part D you must be entitled to Part A and/or under Part B, and be a U.S. citizen or lawfully present in the United States on or before the enrollment effective date.
Which of the following best defines Medicare Part D quizlet?
b) It is a government program, offered only through a private insurance company or other private company approved by Medicare, which provides prescription drug coverage.
Is Medicare Part D prescription drug coverage available to everyone with Medicare?
Yes. As of January 1, 2006, you must belong to a Medicare prescription drug plan.
How and When to Enroll in Medicare Part D
How do you get Medicare Part D?
Once you have Medicare Parts A and B (often called Original Medicare), you're eligible for a Part D prescription drug plan. These plans can vary based on price, coverage, and the formulary—the list of covered prescription drugs.
Who is most likely to be eligible to enroll in a Part D prescription drug plan?
To be eligible to enroll in a Part D prescription drug plan, an individual must be eligible for Medicare, which is typically available to individuals aged 65 and older or certain younger individuals with disabilities.
Which of the following is Medicare Part D cover?
Medicare Part D helps cover the cost of prescription drugs. Part D is optional and only provided through private insurance companies approved by the federal government. However, Part D is offered to everyone who qualifies for Medicare. Costs and coverage may vary from plan to plan.
Which of the following options will enable a customer to obtain prescription drug coverage?
There are two ways to get prescription drug coverage. You can enroll in a stand-alone Medicare Part D plan. This coverage will be in addition to Original Medicare (Parts A and B) and/or a Medicare Supplement plan. You can enroll in a Medicare Advantage (Part C) plan that includes prescription drug coverage.
Which consumer is eligible for a standalone Medicare prescription drug plan?
Enrollment in Medicare Part A and/or Part B: To be eligible for a standalone Medicare prescription drug plan, you must be enrolled in Medicare Part A and/or Part B. This includes individuals who are 65 years or older, as well as certain individuals under 65 with qualifying disabilities.
Who pays for Medicare Part D drugs?
Your drug costs are covered by Medicare. You'll need to join a Medicare drug plan for Medicare to pay for your drugs. In most cases, you'll pay a small amount for your covered drugs.
Can you be denied Part D coverage?
If the drug plan denies coverage, it must notify you (and your doctor, if he/she made the exception request) in writing within 72 hours if you submitted a standard request, or within 24 hours if you submitted an expedited request. The notice must explain the reason for denial and how to continue the appeals process.
Which of the following statements about Medicare Part D is correct?
All four statements about Medicare Part D are correct: Part D must enroll all eligible beneficiaries, PFFS plans may choose to have a pharmacy network but aren't required to, beneficiaries with an MSA plan can only get prescription drug coverage through a standalone PDP, and beneficiaries enrolled in a MA-PPO may ...
What is a dual eligible Part D plan?
Dual Eligible Special Needs Plans (D-SNPs) are Medicare Advantage (MA) plans that provide specialized care and wrap-around services for dual eligible beneficiaries (eligible for both Medicare and Medicaid).
Does Medicare automatically enroll you in Part D?
Enrollment in Medicare Part D plans is voluntary, except for beneficiaries who are eligible for both Medicare and Medicaid and certain other low-income beneficiaries who are automatically enrolled in a PDP if they do not choose a plan on their own.
What are two options for Medicare consumers to get Part D prescription drug coverage Select 2?
You can get a stand-alone Part D plan (also known as a PDP plan). Or, you can opt to get a Medicare Advantage plan that includes drug coverage.
What is direct to consumer promotion of prescription drugs?
It has been argued that direct-to-consumer advertising can influence the doctor–patient relationship, including patients bringing up their need for an advertised, name-brand drug as their primary concern during a doctor visit, and becoming interested in newly-introduced medications that may not have undergone ...
Does Medicare Part D require prior authorization?
Medicare Prescription Drug (Part D) Plans very often require prior authorization to obtain coverage for certain drugs.
How do you qualify for Medicare Part D?
- Have Medicare Part A (Hospital Insurance) or Part B (Medical Insurance).
- Live in the service area of the plan you want to join.
- Be a U.S. citizen or lawfully present in the U.S.
- Complete an enrollment request during a valid election period.
What are the two types of Medicare Part D plans?
Blue Shield offers two Medicare Part D plans; Blue Shield Rx Plus (PDP) and Blue Shield Rx Enhanced (PDP). The plans provide coverage options for your prescription drug costs.
How to buy Medicare Part D?
To sign up for a Part D plan, click Enroll. You'll need your Medicare number and the date your parts A and B coverage began. You may also be able to enroll with an insurance agent or by calling 800-MEDICARE (800-633-4227).
Can you add Medicare Part D at any time?
Your old Medicare drug plan coverage will end when your new drug plan coverage begins. You can also add Part D coverage during the Medicare Advantage Open Enrollment Period (Jan. 1 – March 31) if you're switching from a Medicare Advantage plan to original Medicare.
How much will the Medicare Part D plan cost in 2024?
Part D cost sharing
A monthly Part D plan premium (average estimated premium in 2024 is $46.50) An annual deductible (maximum $590 in 2025) A copayment or coinsurance during the initial coverage period.
Can I have both employer insurance and Medicare Part D?
Generally if you are currently working, your employer's Group Health Plan pays before Medicare Part D coverage. However, if you work for a small firm of 20 or fewer employees, usually your Medicare Part D Plan pays first and the Group Health Plan pays second.