Medicare can be confusing, especially with so many options to choose from! But with a little preparation and a basic understanding of what each type of plan does you’ll make your Medicare search much less stressful!

What is Medicare Part D?

Medicare Part D, otherwise known as Medicare Prescription Drug coverage, is the part of Medicare that provides coverage for eligible drugs prescribed by your doctors. The plan protects you from high drug costs by setting a co-pay or coinsurance for your prescription medication.

Medicare Part D groups eligible drugs into tiers that start at the lowest co-pay/coinsurance amount (tier 1) to the highest co-pay/coinsurance amount (the highest tier for your specific Medicare Part D plan). To ensure you get the most cost-efficient plan, you can check what tier your existing prescriptions are in before selecting a Part D plan.

What does it cover?

The various Medicare Part D plans that are available each have their own list of covered prescribed medications. As previously mentioned, Part D plans categorize drugs into “tiers” based on the out-of-pocket cost. For example, the drugs that fall in the lowest tier are often generic, less expensive versions of more expensive prescription drugs. Higher tier drugs are generally brand name medications, which you will be required to pay more for.

How does it work?

A Medicare Part D plan, which works in tandem with other Medicare coverage, helps reduce the expense of prescription medication. If you will be covered by an Original Medicare plan or Medigap plan for health services, then you should consider a Medicare Part D plan to ensure that prescription medication costs are also covered. If you’re enrolled or planning to enroll in a Medicare Advantage plan that does not offer Prescription Medication coverage you should also enroll in a Part D plan.

Is it expensive?

The out-of-pocket costs, which can include premiums, deductibles, co-payments etc., depend on the following factors:

  • Drug costs allocated by the plan
  • The plan’s deductible
  • Whether you use a pharmacy in your plan’s network
  • Whether or not you qualify for assistance with Medicare Part D costs

It’s important to review all available Medicare Part D plans before selecting one to ensure that you’re getting the most cost-efficient plan that will also save you money for your prescriptions in the long run.

When can you enroll in a Medicare Part D plan?

If you’ve never enrolled in a Medicare Part D plan, then your first chance to enroll is during your seven-month Medicare Initial Enrollment Period, which begins three months before your 65th birthday and continues for three months after your 65th birthday. After your Initial Enrollment Period has passed, you can update your plan during the Annual Election Period, which starts on October 15th and ends on December 7th each year.

Are there any alternatives?

Medicare Advantage plans, commonly referred to as “Part C” plans, are offered by private insurance companies and can offer prescription drug coverage. They replace the coverage provided by Medicare Parts A and B with more affordable co-pays and deductibles, and may include dental, vision, and/or prescription drug benefits. To qualify for a Medicare Part C plan, you must be currently enrolled in Medicare Parts A and B.

How can I find a Medicare Part D plan?

If you’re already enrolled in Medicare coverage and would like change plans during Open Enrollment can help connect you with alternative options in your area! If you’ll be turning 65 within the next 6 months, our team can also help you find great plan choices.

Call us today at (888) 973-0063 to speak to a specialist, or you can request plan information online using our simple form.