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Table of Contents

Getting Started - The Basics

About Enrolling

Costs and Coverage

Problems Getting Your Drugs Under Your Plan

Other Common Problems / Changing Plans

Information for Medicare Providers

Medicare Part D:
Questions and Answers

On January 1, 2006, Medicare benefits expanded into the world of prescription drug coverage. Medicare Part D is highly technical and complex. We've designed this website to help you better understand how to make Part D work for you.

Getting Started - the Basics

What is Medicare prescription drug coverage?

Who is eligible for Part D coverage?

If I have Medicaid (MaineCare) and Medicare, do I need Part D coverage?

What if I already have prescription drug coverage from another source?

Where do I go for help with Part D?

What Part D Plans are available in Maine?

About Enrolling

How do I enroll for Part D coverage?

Is there a deadline to enroll for Part D coverage?

Costs and Coverage

How much does Part D coverage cost?

Will Part D pay for all of my prescriptions?

What if I can't afford Part D coverage?

Problems with Getting Drugs under Your Plan?

My Part D plan denied coverage of my drug. How do I find out why I was denied coverage?

What if my Part D plan determined that my drug was not medically necessary?

What if my drug is not on my Part D plan's formulary?

What if I can't get my drug because my doctor did not obtain prior authorization from my Part D plan?

What if my doctor prescribed a dosage that is not covered by my Part D plan?

What if my doctor prescribed a form (liquid versus pill), or type (generic versus brand) of drug, that is not covered by my Part D plan?

Other common problems / changing plans

What if I can't afford my drug?

What if my Part D plan removes my drug from its formulary?

Can I get my prescription filled at a pharmacy that is not within my Part D plan's network?

What if my drug is not covered by Part D?

Can I change Plans?



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