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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, covers only hospital and medical insurance, leaving prescription drugs uncovered.
There are two options available to choose from for prescription drug coverage. Choosing a Medicare Advantage Plan with either an HMO or PPO network is one available option. Or, if you are a Medicare beneficiary and want to add drug coverage to your plan, Medicare Part D is also an option.
Who is Eligible for Medicare Part D?
If you are eligible for Medicare, then you are also eligible for Medicare Part D coverage. In order to add Part D prescription drug coverage, you must currently be enrolled in Medicare Part A or 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 at the same time. Similar to Medicare Part B, you do not need to enroll in Part D during your initial enroll 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 insurance drug coverage, it is possible to delay the enrollment without any penalty. Outside of your initial enrollment, Part D enrollment is mostly 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 drugs under Medicare Part D. However, which specific drugs will depend on the individual Part D plan you choose. It is important that you make sure the plan you choose covers the prescription drugs or medications that you take.
Each plan will provide a list of the prescription drugs they cover, which is sometimes referred to as a formulary. The list will include at least two drugs in the most commonly prescribed categories to ensure that different medical conditions are met. Most Medicare Part D plans cover at least two drugs per category. Drug plans may change over time as new drugs are released or new therapies or medical information become available. In the event that this happens, you will receive written notice at least 60 days prior to the change.
Your plan’s formulary may also place drugs in different “tiers” in an effort to lower costs. For example, the most generic drugs would go in Tier 1, which would also have the lowest copayment. Whereas, 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 specifically listed in its coverage. Also, some drugs 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. With your Part D plan, you will be charged either a copayment or coinsurance for new prescriptions and refills.
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.
Connect directly with one of our trusted agents to learn which Medicare Part D plan meets your prescription drug needs. We love assisting with your Medicare coverage and ensuring that our clients make the best available choice. If any of this sounds confusing, you’re not alone. We have Medicare agents in your area standing by. Give us a call today!