Prescription costs, donut holes, deductibles, benefits, plans, oh my. Your Medicare Part D plan might seem confusing, but we're here to help! Meet with a pharmacist one-on-one to go over your options, including a detailed review that could potentially save you money.
Every year from October 15th to December 7th is a time period known as Open Enrollment. Within the Open Enrollment Period, eligible individuals can join a plan if they are not on one already, switch to another plan, or drop their current plan. This applies to people enrolled in the Medicare Advantage Plan as well.
Medicare Part D is a prescription drug benefit offered under the United States federal government's Medicare program. It was created in 2006 as a replacement for the former Medicare+Choice program.
The basic idea behind Part D is to provide seniors with access to affordable prescription drugs. To do this, the U.S. government provides subsidies to private insurance companies who then offer coverage for prescription drugs.
To qualify for Medicare Part D, you must meet certain requirements. Eligibility includes those who are 65 or older, people who have received Social Security Disability(SSDI) for more than 24 months, or those who have been diagnosed with end-stage renal disease.
If you don’t sign up for Medicare during your Initial Enrollment Period, you may have a late enrollment penalty. These penalties are for a lifetime and are added to your monthly premium. The penalties are calculated based on how long you go without creditable coverage.
There are two major options for Medicare Part D plans: stand alone and managed care. Stand alone plans are sold directly by insurance companies. Managed care plans are sold through HMOs and PPOs. Both stand alone and managed care plans cover both brand name and generic medications.
Some plans have copays. The specified amount varies depending on your plan. Part D plans will also cover most vaccines, except for those covered in Part B. Part D plans do exclude some drugs from being covered by law, these include certain drugs to treat weight loss or gain, and OTC medications.
You don’t need to enroll in Medicare Part D. Employer, Tricare, and IHS are all considered creditable coverage.