Post-Enrollment FAQs

Post-Enrollment FAQs

Contact Us

Can I still use my current Part D drug card while I am waiting for my new card to arrive?

No. If you changed Medicare Part D plans to another Medicare Part D plan, you will receive a new member ID card from your new Medicare plan that includes the information identifying your new plan.

I did not change my Medicare drug plan from last year, so can I still use my existing ID card this year?

Maybe. In the past, some Medicare plans used the same member ID card for multiple years for members who did not change plans. If you have not yet received a new card for Medicare Part D or Medicare Advantage, get in touch with your Medicare plan’s member services department.

My Medicare plan premiums changed from last year, do I need to notify the Social Security Administration about the premium change?

No. You do not need to notify the Social Security Administration about your Medicare Part D or Medicare Advantage plan premium change. If you have elected to have your monthly premiums automatically deducted from your Social Security check, any increase (or decrease) in monthly plan premiums will automatically be adjusted by Social Security.

When will my Medicare plan premiums start being deducted from my monthly Social Security check?

Within 2 to 3 months. You can expect your Social Security check deductions to begin within 2 to 3 months after the start of the new Medicare plan. Your first deduction will include any previously unpaid premiums. For instance, if deductions begin in February, the first deduction will include both January and February monthly premium payments. So if you did not see your January premium deduction, be sure to budget for less income in February when you will pay two premiums at once.

Please note, if you changed your Medicare plan coverage at the end of the annual open enrollment period (or during the Medicare Advantage Disenrollment Period), the Social Security Administration may need a little time to begin deducting the correct amount from your Social Security check. When the adjustment is made, you will see the old premiums returned to your account and the new premiums deducted. You are still responsible for paying the premiums to the insurance carrier in the interim.

I enrolled in a Medicare Advantage plan with a $0 premium, so do I still need to pay my monthly Medicare Part B premium?

Yes. In order to enroll in a Medicare Advantage plan, you must be covered by Medicare Part A and Medicare Part B.

I am qualified for Medicaid and receive full Medicare Part D extra help, so why is my new Medicare drug plan charging me an extra premium?

If you qualify for the full Medicare Part D Low-Income Subsidy (LIS or Extra Help), Medicare will auto-enroll you into a Medicare Part D plan that qualifies for your state’s $0 monthly premium. However, you have the right to select your own Medicare Part D plan at any time during the plan year. If you select your own plan, Medicare considers you a “chooser” and does not automatically change your enrollment for the next plan year.

I have VA benefits and do not need Medicare Part D, so why am I being charged an extra premium for IRMAA when I am not even enrolled in a Part D plan?

You are not being charged for Part D IRMAA, but rather Part B IRMAA. Income related monthly adjustments amounts (IRMAA) are charged if a Medicare beneficiary earns over a certain amount of income. IRMAA is assessed in addition to both Medicare Part B and Medicare Part D premiums.

I didn’t change my Medicare prescription drug plan, but now some of my medications that were covered last year are not covered by my new plan. What can I do?

If your medications are not covered by your new Medicare Part D plan, there are at least three steps you can take at this time:

1. If your medication is still cleared by the Medicare program, contact your Medicare prescription drug plan and ask for a either a 30-day transition or temporary supply of your medication (Please note that sometimes a particular medication is excluded from the Medicare Part D program and will not be available through your Medicare Part D plan).

2. If you are using the temporary medication supply, you and your physician can seek an alternative drug that is included on your plan’s formulary.


 3. It is possible to file a formulary exception (or coverage determination) with your Medicare Part D plan requesting that your non-formulary medication be covered under your new Medicare plan.


Important: Your Medicare Part D plan will not automatically grant your formulary exception or coverage determination request. Should your plan deny your request, you are able and have the right to appeal the decision on several instances, and enough appeals will get your case in front of an independent group. You can call your plan for an overview of the appeals process.


I just saw that several of my medications covered by my new plan are now subject to Quantity Limits, Prior Authorization, and/or Step Therapy. What does all of this mean?

Even if you did not change Medicare prescription drug plans, it is possible your new Medicare prescription drug plan has implemented some form of utilization management (or drug usage management) in their formulary to keep costs down and protect their plan members.

Utilization management includes such prescription controls, such as:
• Quantity Limits - only allowing for a certain number of tablets per 30 days.
• Prior Authorization- requiring plan approval before a prescription can be filled.
• Step Therapy - having members try lower-costing medications before using a more expensive drug.

Please remember, you always have the right to ask your plan for a formulary exception (or coverage determination) if you wish to be exempted from a specific usage management requirement.


I changed my Medicare Part D plan and still fill my prescriptions at the same pharmacy. Will my prescriptions transfer to my new drug plan?

Yes. If you elect to go with a new Medicare Part D plan and use the same pharmacy, your pharmacy should adjust your prescriptions to and bill your new prescription drug plan automatically – assuming your pharmacy is also a part of your new prescription drug plan’s pharmacy network. Show your pharmacist your new drug plan ID card. Please remember, if your pharmacy is not a preferred network pharmacy for your new Medicare Part D plan, you may pay higher cost-sharing rates.



Note: If you decide to change to a 90-day supply, and your prescriptions are written for a 30-day supply, you will need to ask your doctor for a 90-day supply. Also, as usual, if you decide to switch pharmacies or use a mail-order service, then you would need to transfer your prescriptions to the new pharmacy or mail-order service.



Important: Please keep in mind that your new prescription drug plan may subject some of your medications to Prior Authorization or have Quantity Limits or require the use of Step-Therapy (see question above). In this case, you will need to work with your prescribing doctor to meet these requirements or ask for a formulary exception.

Question: I was in the Donut Hole in December, does the Coverage Gap restart in January or am I still in the Coverage Gap?

Your Medicare Part D plan coverage begins in January of each year and your Coverage Gap will end December 31.

(253) 468-2522​
Puyallup, WA 98371​
Click Here to Email Us