Medicare Part D
Medicare Part D is prescription drug insurance
coverage provided by private companies approved
by Medicare. Here's a look at the Part D basics.
Medicare Part D is prescription drug coverage available for everyone who has Medicare insurance. You
must have at least Part A hospital coverage to purchase Part D prescription coverage. Medicare Part D
is only offered by insurance companies (that have been approved by Medicare), so you have to purchase
coverage through an insurance provider.
You can get Part D in one of two ways:
1. Through a Medicare Prescription Drug Plan (PDP) that adds coverage to your Original
Medicare plan (Medicare Part A and Part B). You can also add PDP to some Part plans
including Private Fee-for-Service and Medical Services Account Plans.
2. Through a Medicare Advantage Plan. These HMO and PPO plans offer Part D coverage in
addition to Part A and Part B coverage.
Enrolling in Medicare Part D
You should join a Part D plan when you are first eligible for Medicare. If you
wait, you could face late penalties that increase the premiums you pay for a
certain period of time. You are eligible to enroll in Medicare and Part D
beginning the 3 months before your 65th birthday and ending the 3 months
after your 65th birthday.
You can also enroll, switch, or drop Part D coverage between November 15
and December 31 each year. If you are enrolling for the first time during that
window and it is not your initial enrollment period, you may have a late penalty.
You won’t face a penalty for missing the initial enrollment period if you had a
creditable prescription drug coverage or if you never enroll in Part D.
How Much Does Medicare Part D Cost?
You’ll typically pay a monthly premium for Medicare Part D. That’s on top of
any premium you pay for Part C. The cost for Part D coverage varies by
insurance provider. If you have prescription drug coverage through an HMO or
PPO, your premium will be included in your overall premium for the insurance.
Your prescription drug coverage may require you to pay a copayment or meet
an annual deductible. The copayment is your share of the cost. For example,
your copayment might be 20% of the cost of the drug. The insurance company
pays the remaining 80%. The annual deductible is the amount you have to pay
out of pocket for your prescriptions before insurance pays anything. Not all
insurance companies have an annual deductible.
Your Medicare Part D plan may have a coverage gap. Medicare covers drug
payments up to a certain point, then stops. At that point, you’re responsible for
paying 100% of your prescription drug coverage for another period before
Medicare begins paying what it calls “catastrophic coverage”.
For example, you and Medicare might spend $2,700 on prescription drugs when coverage gap kicks in.
Then, you pay out of pocket until you reach your $4,350 out-of-pocket max for the year. After that,
catastrophic coverage will only require you to make a small payment on coverage drug through the end
of the year. Some insurance plans will cover your prescription drugs during the coverage gap that reduce
the amount of out-of-pocket you must pay.
Restrictions on Drug Coverage
Some plans have rules for your prescription drug coverage. For example, you may have to contact you
insurance company before having your prescription filled to show that the drug is medically necessary.
Also, your insurance company may place a limit on the number of pills you’re allowed to receive at one
time. Finally, your plan may require you to take a generic drug before covering the “branded” drug
prescribed by your doctor.
Applying for Medicare Part D Coverage
You must apply for Part D directly with the insurance company providing coverage. You can search for an
insurance provider at the Medicare website.
Copyright © 2010 The Money Alert.com. All rights reserved.
All information herein has been prepared solely for informational purposes, and it is not an offer to buy or sell, or a solicitation of an offer to buy or sell any security or instrument or to
participate in any particular trading strategy. The Money Alert does not make any representations or warranties as to the accuracy, timeliness, suitability, completeness, or relevance of any
information prepared by any unaffiliated third party, whether linked to this web site or incorporated herein, and takes no responsibility. All such information is provided solely for
convenience purposes only. The Money Alert is not affiliated with any of the firms or entities listed unless specifically stated. The Money Alert does not provide investment, tax or legal
advice. Please consult the appropriate professional regarding your personal situation.