If you are a Generations Advantage plan member having trouble paying for your Part D or prescription expenses, we may be able to help.
Below you will find information on the Part D cost savings you may qualify for, including reduced drug costs and lower premiums. Additionally, you can explore resources that provide further assistance, including local organizations/contacts and Medicare resources.
For a comprehensive look at your plan's Part D prescription drug coverage, explore the Part D Benefit Guide [PDF].
To review personalized Part D benefit and coverage information tailored to you, sign in to your member portal account.
Martin's Point Generations Advantage Prime, Select, Access, and Value Plus plan premiums include coverage for both medical services and Part D Prescription Drug coverage. Please see the Evidence of Coverage for Prime, Select, Access, and Value Plus Ch. 6, Section 6.1 for more details.
Medicare offers financial assistance (called “Extra Help”) to help pay for Medicare Part D Prescription Drug plan costs. If you qualify, you may pay a lower plan premium and/or lower drug copays.
The amount of Extra Help you get will determine your total monthly plan premium and your covered drug costs as a member of our plan.
Please note Extra Help amounts are determined by each individual state and county. Extra Help for plan premium payments are not applicable to plans with a $0 plan premium.
Extra Help from Medicare may also help lower the costs you pay when you get Part D Prescription Drugs at the pharmacy. If you qualify for this Extra Help, the amount you pay will vary based on your income. The State will notify you what your Extra Help level of cost will be.
If you are eligible for Level One Extra Help, your prescription cost shares will be:
If you are eligible for Level Two Extra Help, your prescription cost shares will be:
If you are eligible for Level Three Extra Help, your prescription cost shares will be:
This new payment option may help you manage your medication costs.
Beginning in 2025, the law known as the Inflation Reduction Act requires all Medicare Prescription Part D plan to offer enrollees the option to pay out-of-pocket prescription drug costs through of capped monthly payments instead of all at once at the pharmacy.
The amount of Extra Help you get will determine your total monthly plan premium.
The tables below show you what your monthly plan premium will be if you get Extra Help. This does not include any Medicare Part B premium you may have to pay.
Plan ID: H5591-015-001
Maine Counties: Lincoln, Oxford, Piscataquis, Somerset, and Waldo
New Hampshire Counties: Belknap, Carroll, Coos, and Grafton
Plan ID: H5591-006-002
Maine Counties: Kennebec, Sagadahoc
Plan ID: H5591-015-002
Maine Counties: Aroostook, Franklin, Hancock, Knox, Penobscot, and Washington
The table below shows you what your monthly plan premium will be if you get Extra Help. This does not include any Medicare Part B premium you may have to pay.
Maine Counties: Androscoggin, Aroostook, Cumberland, Franklin, Hancock, Kennebec, Knox, Lincoln, Oxford, Penobscot, Piscataquis, Sagadahoc, Somerset Waldo, Washington, and York
New Hampshire Counties: Cheshire, Coos, Hillsborough, Merrimack, Rockingham, Strafford, and Sullivan
.
If you are unsure if you qualify for assistance or have questions, there are several resources and contacts that can provide you with more information. See below for details.
If you aren't getting Extra Help, you can see if you qualify by contacting any of the following:
Current Members: Call 1-866-544-7504 (TTY: 711)
Not a member? We can still help! Call us toll-free at 1-855-455-7224 (TTY:711)
Call anytime from 8 am—8 pm, seven days a week from October 1 - March 31, and Monday through Friday the rest of the year
Call 1-800-Medicare (1-800-633-4227)
For TTY/TDD users: 1-877-486-2048
Available 24 hours a day, 7 days a week
Call 1-800-321-5557
TTY/TDD users should call 1-800-423-4331
Contact your local office by calling:
For TTY/TDD users: 1-800-735-2964 (access relay for all NH counties)
Call 1-800-772-1213
For TTY/TDD users: 1-800-325-0778
Available 7 am-7 pm, Monday through Friday
Whether you’re exploring plan options or already a Generations Advantage member, our team is ready to help.
Prospective Members: Call us at 1-800-961-4572 (TTY: 711)
Current Members: Call Member Services at 1-866-544-7504 (TTY: 711)
