Medicare Part-D Prescription Drug Plan

Overview

• Express-Scripts Incorporated (ESI) is the carrier for this plan. Visit their online portal here: Express-Scripts Incorporated (ESI).
• The retiree or their covered spouse must have Parts A & B of Medicare in order to participate in the plan.
• A retiree must be receiving a retirement allowance from an eligible plan  and must apply within 31 days of a qualifying event.
• The Dakota Retiree Plan is bundled with the Medicare Part D Prescription Drug Plan.

Carrier Contact Information   Forms

Additional Information

• Summary Plan Description
• Income Related Monthly Adjustment Amounts (IRMAA)
• Late Enrollment Penalty (LEP)
• Low Income Subsidy (LIS)
• Creditable Coverage Notice
• ESI 90 Day Supply North Dakota Pharmacy Network
• Medicare Drug Coverage Under Part A, Part B, Part D
• 2021 Medicare Part-D ESI Formulary List
• HIPAA Privacy Notice
• 2021 Medicare Part-D Benefits Overview