Enroll in First UA Medicare Part D

Step 1 of 6

Enrolling in our Plan is easy. You may enroll online, over the telephone, or by paper enrollment form.

To enroll online, simply read the disclaimer below to begin. This is the fastest and easiest way to enroll. Once you click the submit button, the system will walk you through the enrollment process in six easy steps.

To enroll over the telephone or to request a paper enrollment form, please call our Customer Service Department, 7 days a week, from 8 am to 8 pm in your local time zone.

Toll-free: 1-866-524-4171
Hearing-impaired callers using TTY/TDD equipment: 1-866-524-4172

When you are finished with your enrollment, we will submit your information to the Centers for Medicare & Medicaid Services (CMS) for approval. When we receive approval of your enrollment form from CMS, we will send your member identification card and Plan information in the mail within 7-10 business days.

Disclaimers:

First United American Life Insurance Company is a Medicare-approved Part D sponsor. Plan sponsors can choose not to renew their contract with CMS, and CMS may also refuse to renew the contract, thus resulting in a termination or nonrenewal. This may result in termination of the beneficiary's enrollment in the plan. In addition, the plan sponsor may reduce its service area and no longer offer services in the area where the beneficiary resides. Eligibility Requirements To be eligible for and to enroll in First UA Medicare Part D, you must be: Eligible to receive Medicare benefits under Part A or enrolled in Part B. A resident in the First UA Medicare Part D's service area (state of New York). Important Information You may only be enrolled in one Part D plan at a time. If you are enrolled in a Medicare Advantage (MA) plan, you may not enroll in First UA Medicare Part D unless you are a member of a Private Fee-for-Service (PFFS) or a Medical Savings Account MA plan (MSA). Pharmacy Information First UA Medicare Part D Prescription Drug Plan (PDP) has formed a network of pharmacies. You must use a network pharmacy to ensure you receive plan benefits. Our Medicare Part D plan may not pay for your prescriptions if you use an out-of-network pharmacy, except in certain cases. The pharmacies in our network can change at any time. If you want a Pharmacy Directory, click on the Medco pharmacy lookup or call our Medicare Part D Customer Service at 866-524-4171 (TTY/TDD: 866-524-4172) to request the most current list. Medicare Part D Extra Help You may be able to get extra help to pay for your prescription drug premiums and costs. To see if you qualify for getting extra help, call: First UA Medicare Part D Customer Service at 1-866-524-4171. TTY users should call 1-866-524-4172, seven days a week from 8 am to 8 pm Eastern time zone. 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/seven days a week. The Social Security Office at 1-800-772-1213 between 7 am and 7 pm, Mon. through Fri. TTY users should call 1-800-325-0778. Your State Medicaid Office People with limited incomes may qualify for Extra Help to pay for their prescription drug costs. If eligible, Medicare could pay for 75% of drug costs including monthly prescription drug premiums, annual deductibles, and co-insurance. Additionally, those who qualify will not be subject to the coverage gap or a late enrollment penalty. Many people are eligible for these savings and don't even know it. For more information about this extra help, contact your local Social Security office or call 1-800-MEDICARE (1-800-633-4227), 24 hours a day/seven days a week. TTY users should call 1-877-486-2048. If you qualify for extra help for your Medicare prescription drug plan costs, the amount of your premium and cost at the pharmacy is less. Once you are enrolled in a First UA Medicare Part D Prescription Drug Plan (PDP), Medicare tells us how much assistance you receive. We then send you information on the amount of premium you will pay. Medicare Supplement (Medigap) Policies with Part D If you have a Medicare Supplement (Medigap) policy that includes prescription drug coverage, you must contact your Medigap provider to tell them you joined a Medicare prescription drug plan. If you keep your Medigap policy, your Medigap provider removes the prescription drug coverage portion of your policy and adjusts your premium. Under certain circumstances, you can buy a different Medigap policy without prescription drug coverage sold by your Medigap provider. Your Medigap provider cannot charge you more based on any past or present health conditions. Call your Medigap provider for details.

Click here for a printable version of these disclaimers.

I acknowledge that I have received and reviewed the
First UA Medicare Part D Summary of Benefits.

This website is intended to provide you with information about Medicare prescription drug coverage so you can make an informed decision about how Medicare Part D can help you manage your prescription drug costs. First United American Life Insurance Company is a Medicare-approved Part D sponsor.