Guide to Medicare Part D

On January 1, 2006, Medicare benefits expanded into the world of prescription drug coverage. This new benefit, often called "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 (a Kentucky Medical Card) 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 Kentucky?

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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Reviewed August 2009

This online guide was adapted with permission from Maine Legal Services for the Elderly. We extend our thanks to them.