Medicare Part D Helps Subsidize Costs of Prescription Drugs for Seniors
Medicare Part D offers prescription drug coverage for every person that has Medicare. You can get drug coverage in two ways. First, a Medicare Prescription Drug Plan can be used with Original Medicare, some Medicare Private Fee-for-Service Plans, and Medicare Medical Savings Account plans.
Second, you can receive prescription drug coverage to a Medicare Advantage Plan whether it’s an HMO or PPO.
Video: Eligible for Medicare Part D?
How to Join Medicare Part D
You should join a prescription drug plan when you first become eligible. Otherwise, you might face a late enrollment penalty. You are able to enroll in a Medicare drug plan when you first become eligible for Medicare. That is, 3 months before you turn 65 or 3 months after you become disabled. You can also join between November 15 and December 31 of each year. You can join the plan you’ve chosen by completing the application, and either calling the plan or enrolling online.
Video: Medicare Part D
What Prescriptions are Covered
Each plan has its own list of drugs that are covered. You can typically find out covered drugs by contacting the plan or viewing its website. To receive coverage for certain drugs, you or your doctor must contact the plan before you fill the prescription. The plan might require your doctor to show proof that the drug is medically necessary. There may be limits on the number of pills you can receive at one time. Finally, you may be required to use a lower cost drug before using the one specifically prescribed by your doctor.
Requirements for Medicare Part D
For a Medicare Prescription Drug Plan, you need to have either Medicare Part A or Part B- For a Medicare Advantage Plan, you need to have both Part A and Part B.
- You must also live in the drug plan’s service area for Medicare Advantage Plan.
- You need to be over 65 or under 65 with certain disabilities or have End-Stage Renal Disease
- You must sign up when you’re first eligible to enroll - that is, 3 months before you turn 65 or 3 months after you become disabled.
- If you wait to enroll, you’re subject to a late enrollment penalty.
Switching to Another Plan
You can switch to another plan between November 15 and December 31 each year. You don’t have to worry about canceling your old plan. That plan will automatically end once your new plan begins. Medicare will send a letter letting you know when your new coverage begins (typically January 1 of the next year).
Video: Medicare in Simple Terms
Medicare Part D Costs
Each Medicare prescription drug plan has different costs. How much you end up paying will depend on your plan, the drugs you purchase, the pharmacy you use, and whether you have a low income that qualifies you for extra help with your Medicare Part D costs.
You’ll be responsible for paying your:
- Monthly premium
- Yearly deductible
- Co-payments or co-insurance
- Coverage gap (costs between your plan’s coverage and your maximum out-of-pocket limit)
Though you’ll face some prescription drug costs even with Medicare Part D, they’ll be much less than if you had to pay completely out of pocket.