Enrollee Rights: Requesting Coverage Determinations and Appealing Decisions •Part D Plan Sponsors must provide access via a secure website or secure e-mail address on the website for enrollees to quickly [...]
Standard Part D Benefits for 2023 For 2023, the standard benefit requires the beneficiary to pay: •a $505 deductible •25% of prescription drug costs during the initial coverage phase – [...]
Part D Premiums •Part D plans generally charge a premium. o Typically, a higher premium means lower out-of-pocket costs for the plan. •Part D enrollees have three options for [...]
Part D Initial Enrollment Period Enrollment Periods – Part D Initial Enrollment Period (IEP) •The Part D IEP •Individuals eligible for Medicare before age 65 (for example, because of disability) [...]
Transition Requirements •Enrollees initially enrolling in Part D, those switching plans, and current enrollees affected by formulary changes must receive coverage of at least a one-month fill (unless a lower [...]
A common feature of Part D benefit structures and formularies is cost sharing tiers. •Tiered cost sharing means grouping Part D drugs into different cost-sharing levels within a Part D [...]
