Essential Coverage for Prescriptions

Individual Medicare Prescription Drug Plans (Part D)

Medicare Part D is standalone prescription drug coverage offered by private insurance companies approved by Medicare. These plans are designed to help Medicare beneficiaries pay for the costs of prescription medications, providing essential financial protection and peace of mind.

Why Should You Consider a Medicare Part D Plan?

Part D coverage may help lower some of your prescription drug costs. Even if you don't take many medications now, enrolling when first eligible can help you avoid the Part D Late Enrollment Penalty (lifetime penalty) later. These plans feature a formulary (a list of covered drugs) and defined cost-sharing tiers, ensuring you can manage your medication expenses predictably.

What Medicare Part D Plans Offer:

Coverage for Medications: Helps pay for prescription drugs, both generic and brand-name
Formulary: Each plan manages a list of covered drugs, categorized by tiers that determine your copayment
Defined Cost-Sharing: Plans typically involve a monthly premium, an annual deductible, and copayments or coinsurance for drugs
Catastrophic Coverage: Provides protection against very high out-of-pocket spending on medications

When to Enroll in Standalone Part D (Prescription Drug Plans)

Standalone Medicare Part D plans must be enrolled in during specific enrollment periods throughout the year. Your timing matters immensely when enrolling in a PDP plan:

Initial Enrollment Period (IEP): This is the first time you can enroll in a Part D plan. It aligns with your Original Medicare IEP, starting three months before the month you turn 65 and ending three months after your birthday month
Annual Enrollment Period (AEP): This is the time when most changes are made. It runs from October 15th through December 7th each year. During the AEP, you can join or switch plans, or you can enroll in an MAPD plan to get your drug coverage, and coverage starts on January 1st of the following year
Special Enrollment Periods (SEPs): These are times outside of the standard windows that allow enrollment due to specific life events, such as moving, losing current coverage, or qualifying for Extra Help (apply with the Social Security Administration)
Late Enrollment Penalty: If you go 63 days or more without creditable drug coverage after your IEP ends, you may have to pay a lifelong late enrollment penalty added to your Part D premium. If you qualify for Extra Help, you do not pay a late enrollment penalty

What is Extra Help (Low-Income Subsidy - LIS)?

Extra Help is a federal program that assists eligible individuals with limited income and resources in paying the costs associated with Medicare Part D Prescription Drug Plans. This assistance can significantly reduce your Part D plan's premium, deductible, and copayments/coinsurance. Qualification is based on income and assets, and receiving other benefits like Medicaid or SSI often grants automatic eligibility. Crucially, qualifying for Extra Help grants you a Special Enrollment Period (SEP), allowing you to join, switch, or drop a Part D plan outside of the standard windows.

Finding the right Medicare Part D plan for your needs is easy. Speak with an Independent Licensed Agent to compare local plan options, focusing on which plan's formulary best covers your specific prescriptions and preferred pharmacy.

IMPORTANT MEDICARE DISCLOSURE

We are not connected with or endorsed by the U.S. government or the federal Medicare program. The information disclosed here is not to be considered exhaustive. For complete Medicare information, utilize official sources. Visit Medicare.gov or call 1-800-MEDICARE. You can also call your local State Health Insurance Program or visit Shiphelp.org. For enrolling in Parts A and B, call the Social Security Administration at 1-800-772-1213 or visit SSA.gov.

Helpful tip:

When securing prescription drug coverage (Part D), you have three main options:

Original Medicare + Part D: You can purchase this plan separately to work alongside Original Medicare
Original Medicare + Part D + Medigap: You can purchase this plan separately to work alongside Original Medicare AND a Medicare Supplement Insurance (Medigap) plan
Medicare Advantage Prescription Drug Plan (MAPD): You can receive drug coverage by enrolling in a Medicare Advantage (Part C) plan that includes prescription benefits

Your choice depends on whether you prefer the provider flexibility of Original Medicare (with optional Medigap) or the all-in-one approach of Medicare Advantage.

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Medigap | Part C

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Essential Coverage for Prescriptions

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Frequently Asked Questions

Is CHL Insurance Solutions an insurance company?

No, we are not an insurance company; we are a licensed insurance agency. This means we do not issue or underwrite the policies. Our role is to provide you with plan advice, explain your coverage options, and assist you with the enrollment process.

How much do you charge for your services?

We do not charge you any fees for our guidance or enrollment assistance. Our compensation comes directly from the insurance carrier you choose, which means you receive our personalized help at absolutely no cost to you.

Do you work with multiple carriers?

Can I expect support after enrollment?

Absolutely! Our support does not stop after enrollment. We offer our clients continued post-enrollment assistance with administrative tasks and are here every year during Open Enrollment to ensure your plan remains the best fit.