What is Medicare Part D?
Medicare Part D serves as a prescription drug coverage plan that helps beneficiaries obtain prescription drugs at more affordable rates. Original Medicare, Part A, and Part B cover only hospital and medical insurance, leaving prescription drugs separate.
Medigap plans do not include the Stand-Alone Medicare Part D coverage. Seniors tend to purchase a drug plan in addition to their Medigap plan unless they have other creditable coverage.
Who is Eligible for Medicare Part D?
If you are eligible for Medicare, then you are also eligible for Medicare Part D coverage. To add Part D prescription drug coverage, you must currently be enrolled in Medicare Part A, Part B, or both. Unlike Original Medicare, Medicare Part D is only offered through private insurance plans. Consider enrolling in a Part D plan if you are not covered for prescription drug coverage, as waiting will come with premium penalties.
Enrolling in Medicare Part D
If you have Medicare Part A or Part B, you can enroll for Medicare Part D simultaneously. Like Medicare Part B, you do not need to enroll in Part D during your initial enrollment period at age 65, but the monthly premium may increase the longer you wait. However, if you are still working at the age of 65 and receiving employer creditable insurance drug coverage, you can delay the enrollment without penalty. Outside of your initial enrollment, Part D enrollment is mainly limited to an annual enrollment period.
How Do I Enroll in Medicare Part D?
Great question. We get this question asked so often that we created a “straight-to-the-point” video on it. If you have questions after watching this video or wish to shop plans in your area, please reach out to us at 1-888-227-6836.
Medicare Part D Coverage & Benefits
Part D covers both brand-name and generic drugs. The federal government requires guaranteed coverage to certain medications under Medicare Part D. However, which specific drugs will depend on the individual Part D plan you choose. You should make sure the plan you select covers the prescription drugs or medications you take if available through Part D. Some medicines are not available through Part D, and folks find other ways to buy them.
Each plan will list the prescription drugs they cover, which is referred to as the formulary. Drug plans may change as new drugs are released, or new therapies or medical information becomes available. If this happens, you will receive written notice at least 60 days before the change.
Your plan’s formulary may also place drugs in different “tiers” to lower costs. For example, the most generic drugs would go in Tier 1, also having the lowest copayment. At the same time, non-preferred brand-name drugs would be in a higher Tier 3 and also carry a higher copayment. This is something to keep in mind when choosing your plan.
It is important to note that your plan won’t cover any drugs excluded by Medicare or drugs not explicitly listed in its coverage. Also, some medications may already have coverage under Medicare Part A or B and are therefore not covered by Part D.
A licensed agent can help you determine if Medicare Part D fits your current needs. Connect directly with one of our agents to learn more with no obligation.
Medicare Part D Costs
Part D plans generally charge a monthly premium. Some plans may also charge an annual deductible. You will be charged either a copayment or coinsurance for new prescriptions and refills with your Part D plan.
The out-of-pocket costs you pay will depend on which Part D plan you choose. Additionally, the area in which you live determines what is offered in your Part D drug plan. For this reason, you want to make sure you understand the coverage provided by the plans in your area. A licensed agent can walk you through the different plans and ensure the plan you choose covers your prescription drugs at the best available price.
We look forward to assisting you with your Medicare coverage and ensuring that our clients choose the right plan. If any of this sounds confusing, you’re not alone. We have Medicare agents in your area standing by. Give us a call today! Connect directly with one of our independent agents to learn which Medicare Part D plan meets your prescription drug needs.
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