November 14, 2014

Medicare PlaybookMedicare Playbook

Are your prescription medications covered by Medicare? If they are, you should check your plan because Medicare Part D plans are changing and there might be a better option. Use this guide to compare plans and find one that is best for you.

If you or a family member receives Social Security Disability Income (SSDI), prescriptions are probably covered by a Medicare D plan. Medicare Part D open enrollment is the time of year when you can look at prescription drug plans in Medicare and keep your current plan or sign-up for another one. In 2015 all Part D plans are changing so now is the time to look. Plans are making changes to benefits and costs, and there are new plans in many areas of the country.

So, how could your Medicare Part D plan change?

Your current plan could change:

  • The monthly premium
  • The annual deductible
  • Your share of the costs (co-payment or coinsurance)
  • The list of the drugs it covers (formulary)
  • Additional coverage, if any, it offers beyond the discounts in the coverage gap
  • Use of policies that may restrict access to certain drugs, such as:
    • Requiring your doctor to justify why you need a certain drug before the plan will pay for it (prior authorization)
    • Requiring your doctor to prescribe a different drug in the same class of drugs first (step therapy)
    • Only letting you buy a certain amount of a drug at a time (quantity limits)

Use Medicare's plan finder to check to see what your plan is and if it still meets your needs. Enrollment for Medicare prescription drug coverage is open until Dec. 7, 2014.

The 2015 Medicare Prescription Drug Annual Open Enrollment guide is an easy read to help you explore the options. The guide is produced by Medicare Access for Patients Rx (MAPRx). NAMI is a member of MAPRx, which brings together organizations serving beneficiaries, family caregivers and health professionals to improve access to prescription medications and safeguard the well-being of Medicare Prescription Drug Coverage (Part D) beneficiaries.

Read more about the changes to Medicare Part D.

Submit To The NAMI Blog

We’re always accepting submissions to the NAMI Blog! We feature the latest research, stories of recovery, ways to end stigma and strategies for living well with mental illness. Most importantly: We feature your voices.


NAMI HelpLine is available M-F, 10 a.m. – 10 p.m. ET. Call 800-950-6264,
text “helpline” to 62640, or chat online. In a crisis, call or text 988 (24/7).