Prescription Drug Plans
FAQ’s (Part D)
How do I pay my Medicare Part D Prescription Drug Plan premium?
- At time of application, you chose to pay your Plan’s premium either by automatic bank draft, direct invoice, or deduction from your Social Security Income check (if collecting)
- If you are unsure of what payment method you selected, contact HTA.
I requested my Medicare Part D premium to be deducted from my Social Security Income check, but got an invoice. Do I need to pay it?
- Yes. It can take up to 90 days for Social Security to start the Medicare Part D premium deductions.
- In the meantime, your Medicare Part D carrier will invoice you for any premium due. Please pay any premium that you are invoiced for.
- You will receive a letter from Social Security notifying you once the deduction is successfully setup.
I requested my Medicare Part D premium to be automatically deducted from my bank account, but got a coupon book or invoice from my plan anyway. Do I need to take action?
- Some carriers still send coupon books as “back-up” and it is not necessary to be alarmed. However, since some banks may reject automatic bank deductions, it is best practice to make sure you see the first month’s premium deduction. If you have any concerns or questions, please reach out to HTA.
I requested my Medicare Part D premium to be automatically deducted from my bank account. When will this occur?
- Some Medicare Part D Plans may initiate their monthly draft as late as the 17th each month.
- Once initiated it can take up to 10 business days to post in your bank account. Please know, all Medicare Part D plans draft premiums for the current month (Ex: January’s premium is drafted in January).
What is an Income Related Monthly Surcharge Amount (IRMAA)?
If you are in a high income bracket, you will pay an IRMAA in addition to your Medicare Part D plan premium. The IRMAA is a surcharge imposed by the Federal Government. The surcharge will be sent via invoice if you are not collecting Social Security Income. If you are collecting Social Security Income , then it will be deducted from your check. This surcharge will be indicated as “Part D IRMAA.”
Do I have a deductible?
Many Medicare Part D plans have an annual deductible which must be met before you will have your co-pays or co-insurance. The maximum allowable Part D deductible in 2023 is $505. Please refer to your Plan’s Summary of Benefits for further information on your deductible. If you have any concerns or questions, please reach out to HTA.
What is the Coverage Gap?
Every Medicare Part D Prescription Drug Plan (PDP) has 4 stages of coverage. Whether you purchase a standalone PDP or you have PDP coverage through your Medicare Advantage Plan, you will have 4 stages of coverage. For more detailed information on Medicare Part D Prescription Drug Plans and how the stages of coverage work, please visit our Part D Informational Page.
What pharmacy may I use to fill my medications?
Each Part D plan has designated ‘Preferred’ and ‘Standard’ Pharmacies. Using a preferred pharmacy often will have lower medication costs for you. Please contact HTA to find out which Pharmacies are preferred with your plan.
I wish to use mail order to fill my medications. May I do this?
Yes you may. However, each Medicare Part D Prescription Drug Plan has a designated mail order pharmacy partner. When you enroll in your Medicare Part D plan, the plan will send you a welcome packet. Instructions on how to set up mail order either online or via phone will be included in the packet. If you wish to discuss your pharmacy options further please call or email HTA.
I was at the pharmacy and they said my medication was not covered!
Pharmacist often use the words “not covered” to indicate you have a deductible which must be met first. Pharmacists are not Medicare specialists and they are not aware of your Medicare Part D Plan’s benefits. Do not panic! At HTA we are here to help you understand your Plan’s benefits and we have a dedicated Policyholder Services team which is here to answer all your questions. Regardless of your concern, HTA should be your first point of contact.
I received a letter from my Medicare Part D Prescription Drug Plan and it said my medication wasn’t covered!
Some medications may have quantity limits (QL), prior authorization (PA) or step therapy (ST) restrictions on medications. Per Medicare regulations, Part D Plans are required to inform you if you fill a medication with one of these restrictions. Unfortunately, the letters are poorly written and must be read in their entirety to determine the restriction present and what, if any, action need be taken. Do not panic! At HTA we are here to help. Please call HTA with the letter in hand or scan and email a FULL copy of the letter so we may advise you.
May I use outside discount drug programs (like GoodRx) with my Medicare Part D Plan?
Generally speaking you can use either your Part D plan or a drug discount card to purchase your medications. You cannot use both plans for the same medication. Be mindful that many Medicare Part D Prescription Drug Plans have deductibles. Therefore, your medication cost may be high at first, but after your deductible is satisfied the cost may significantly drop. If you fill your medications outside of your plan, the price you pay will not go toward satisfying your deductible. In some instances it may make sense to pay the higher cost of the medication under your Part D Plan and know that the cost will reduce once the deductible is satisfied. If you wish to have assistance in determining what the most cost effective option may be for a particular medication, please call or email HTA.
I have a question regarding my Medicare Part D benefits. Can you help?
Yes! We understand Medicare Part D plans can be confusing, so if you have any questions regarding your coverage, please call or email HTA. We have a dedicated Policyholder Services team which is here to answer all your questions. Regardless of your concern, HTA should be your first point of contact
I was prescribed a new medication and want to understand what it will cost me. Can you help?
Yes! We understand, it can be important to know the cost of your medication before filling it at the pharmacy, so please call or email HTA. We have a dedicated Policyholder Services team which is here to answer all your questions. Regardless of your concern, HTA should be your first point of contact.
I lost my Medicare Part D Prescription Drug Plan member card or plan documents. What do I do?
You will need to call your plan’s member services to request a new card and/or plan documents. Unfortunately Medicare Part D carriers do not allow anyone other than the member to make such requests. If you need your plan’s member services number, please email or call HTA and we will be happy to provide it.
I plan to travel. Can I use my Medicare Part D Prescription Drug Plan elsewhere?
Yes! You may utilize your coverage anywhere in the United States. However, if you make a permanent move to a different State, we may need to take action with your Medicare Part D Plan to ensure your coverage remains in force. Please reach out to HTA as soon as possible so we may assist you.
How does the new Inflation Reduction Act affect my Part D coverage in 2023?
You may have heard news about the Inflation Reduction Act and how it will reduce prescription costs in Medicare. Visit our Inflation Reduction Act and Medicare Prescription Costs webpage for more detail
For more information, check out:
- Our glossary of common Medicare terms.
- Our informational page on Medicare Part D Prescription Drug Plans.