Medicare Part D Drug Coverage

D is for Drugs and Medicare Part D covers prescription drugs not covered under Traditional Medicare. Learn More with the articles below

Medicare Part D Insurance

Medicare Part D insurance is the newest addition to Medicare—it’s the prescription drug coverage that’s got everyone talking.  What’s the big deal?  Probably the fact that this coverage helps to protect seniors against the very real financial risk of needing extremely expensive prescription drugs to maintain a healthy lifestyle. 

Who is Eligible for Medicare Part D Insurance?

Everyone who is already enrolled in Medicare.  Even if you need brand-name prescription drugs.  Even if you have very expensive prescriptions for pre-existing conditions.

How Does this Medicare Prescription Drug Coverage Work?

You can enroll in Medicare part D insurance as soon as you become eligible for Medicare, which is 3 months before you turn 65, through 3 months afterward.  If you miss this window to sign up, there are open enrollment periods during each calendar year that are updated by the Federal government each year, however you may pay a penalty.

Your decision about how to obtain prescription drug coverage depends on the kind of health care coverage you have now. There are 3 different ways to enroll in a prescription drug plan:

1) Join a stand-alone Medicare prescription drug plan

2) Join a Medicare Advantage Plan that includes prescription drug coverage

3) Join another Medicare health plan that offers drug coverage

Regardless of how you choose to enroll in prescription drug coverage, having Medicare drug coverage will help you by covering both generic and brand name prescription drugs at pharmacies right in your home town. Ready to get started with Medicare Part D? Click here for Medicare Part D Prescription Plans.

Just like any other insurance, when you enroll in a Medicare Part D plan, you can expect to pay a monthly premium, which varies by plan, and a yearly deductible. But even once you are covered and pay your premiums, your prescriptions are generally not free.  You can expect to pay at least a part of the cost of your prescriptions, including a copayment or coinsurance. These costs will vary depending on which plan you choose, so pay attention when you shop for a plan. Some plans may offer more coverage and additional drugs for a higher monthly premium. If you have limited income and resources, and you qualify for extra help, you may not have to pay a premium or deductible, but qualifications for this assistance are very specific.  For more information on how to qualify for assistance, visit the social security website.

What Now?
If you want personalized help in selecting a plan, contact a Medicoverage agent.

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Medicare Part D Explained

Medicare Part D is a new drug benefit designed to help seniors pay for the cost of their prescription medications. The program is part of the Medicare Prescription Drug Improvement and Modernization Act of 2003.

Q: How do Medicare Parts A, B , C and D differ?

A: See below for details on the 4 parts of medicare.

Medicare Part A: Covers institutional services - most Medicare eligibles are automatically enrolled.

Medicare Part B: Covers professional services - requires enrollment and premium; beneficiary portion is typically deducted from the Social Security check.

Medicare Part C: Full replacement product (Medicare Advantage) for Medicare Part A and Medicare Part B - government pays private health plans what it estimates it would have paid for Parts A and B; beneficiary must enroll in Part B; any additional premium for Part C is collected by the Part C plan.

Medicare Part D: The new drug benefit designed to help seniors pay for the cost of their prescription medications.  With Part D, Medicare shares the cost of the prescription drug benefit with the retiree.

Q: How will the Part D program work?

A: Medicare will offer the Part D benefit by contracting with private companies, also referred to as Prescription Drug Plan Sponsors (PDPs) or Medicare Advantage Drug Plan Sponsors (MA-PDs). Medicare beneficiaries will have the opportunity to purchase the Part D benefit from a PDP in their area. This is similar to the process that Medicare used to offer the Medicare-approved drug discount card program.

Q: What are Medicare Part D’s key advantages?

A: The Medicare Part D benefit is expected to reflect the following:
1.  Access to a wide pharmacy network, including national chains as well as independent pharmacies
2.  Competitive discounts
3.  Point-of-sale drug claim processing
4.  Mail service
5.  Medical therapy management programs

Q: Who is eligible for the Part D drug benefit?

A: All individuals entitled to Medicare Part A or enrolled in Part B will qualify for Part D coverage. Ready to sign up for a Prescription Plan? Go to the Medicare Part D Prescription Overview.

Q: Will late penalties apply if customers do not immediately enroll in Medicare Part D?

A: A late penalty will apply when Medicare-eligible individuals without creditable coverage do not enroll in Part D during their initial enrollment period. This penalty was designed to encourage beneficiaries to sign up for Part D drug coverage at the youngest possible age, keep overall program costs more affordable and to remain consistent with the penalty used for delayed enrollment into Medicare Part B.

Q: Is enrollment in Medicare Part D mandatory?

A: In general, Medicare Part D is a voluntary prescription drug benefit and will not automatically be added to a customer’s Medicare benefits. However, individuals eligible for both Medicaid and Medicare will be automatically enrolled.

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