As a Medicare Beneficiary you have a slew of decisions to make. One of the most important ones is selecting a Prescription Drug Plan. To some beneficiaries, this is not a priority if they are not currently taking any prescription medications. While this may be the case now, no one can guarantee this to be true for the future, because let’s face it, anyone can experience a health shift. To avoid making this decision now could be costly for you in the future. By choosing to protect yourself now, you are saving yourself money and headaches down the road, while ensuring you have access to the prescription medications you may need.
Medicare approved prescription drug plans, also called Medicare Part D, are plans offered by private health insurance companies. If you do not get this coverage when you first become eligible, you will most likely have to pay a late enrollment penalty. All plans have to conform to state and local insurance rules, but they are different because of the types of drugs covered and the amount of coverage. To give you even more choices, some insurers even offer tiered plans with different levels of coverage.
How to Get Medicare Prescription Drug Coverage?
There are two ways to get Medicare prescription Part D plans:
- Stand-alone: On their own, Part D Plans, sometimes called PDPs, add prescription drug coverage to Original Medicare. People who have Original Medicare, a Medigap policy, or a Medicare Advantage plan without drug coverage might purchase a PDP.
- With Medicare Advantage: Some Medicare Advantage (MA) plans, usually HMOs and PPOs, package Part D prescription drug coverage with health insurance. If your MA plan includes drug coverage, you do not need to buy a separate prescription policy. In fact, if you do sign up for a Part D plan, and your Part C (MA) plan already has prescription coverage, you could get disenrolled and returned to Original Medicare.
Which Drugs Are Covered?
Typically, insurers encourage their members to get generic drugs whenever possible. With some newer drugs, that is not possible, and brand names are still covered, but they are usually not 100 percent covered. In any case, each plan or insurer has something called a formulary. A Formulary is a list of specific generic and brand name drugs that the plan covers. All plans must carry at least two drugs in the same class UNLESS only one is available.
How much does Medicare Part D cost?
Each plan has a monthly premium, and you may have this deducted from your social security in the same way that your Part B premium gets deducted. If you join an MA plan that already includes prescriptions, you just pay the additional premium (if any) for your MA plan. Typically, prescription policies with higher coverage levels may have higher premiums. We can help you compare prices, plans, and covered drugs at any time.
For many Medicare recipients the cost of their medications is more important than the Part D premium.
The cost of prescription medication will depend upon two things:
- The medication that you need
- The plan you select
Let us help you find the Medicare Prescription Drug plan that is best for you!
At Trusted Senior Specialists, our experienced independent Medicare health plan agents know how to compare lists of covered drugs and each client's medications to find the best solution. The right answer will depend upon where you live, the medication you take and your budget. Our goal is to help each of our clients find the right Medicare supplements, Medicare Advantage, and/or Part D plan.