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...More Info About Medicare Part D
Medicare Part D is the most recent addition to the government-sponsored health insurance program for those over 65. This part of Medicare specifically addresses prescription drugs, which weren't previously covered. It went into full effect on Jan 1, 2006.
Part D helps with the costs of the necessary prescription drugs many Medicare recipients need.
How Part D Works
Unlike Parts A and B of Medicare, Part D benefits are paid out through private insurance companies rather than the government.
The only way to receive benefits from Part D is to enroll in a Prescription Drug Plan (PDP) or a Medicare Advantage Plan (MA) offered through an insurance company. When enrolled in a Part D plan, you pay premiums, deductibles, and co-payments for prescription drug coverage. It works similarly to traditional health insurance.
There are many different PDPs and MAs, and you want to be sure you know what you need and what you can afford. You should also make sure your specific drugs are covered.
Enrolling In Part D
To enroll in Medicare Part D, it's best to do it when enrollment is open. This year it starts on November 15th and ends December 31st.
One condition of Part D is that you must choose to enroll, but if you don't do so by the deadline you pay a 1% penalty for your current Medicare coverage. This 1% applies to all of your future premiums - so if you are enrolled in any other part of Medicare, you should also enroll in Part D to avoid extra costs.
The only exception is people who have both Medicare and Medicaid - they are automatically are enrolled in a prescription drug plan.
Your Costs
In 2006, the average deductible was $250. And when you get your prescription filled, you pay 25% of the cost as a co-payment.
A very important thing to know about Part D plans is the coverage gap - sometimes called the "doughnut hole." It refers to the gap in coverage between $2,250 and $3,600. Once you've reached prescription drug costs of $2,250, you don't receive any coverage until the costs reach $3,600. That means if you go through the doughnut hole, you'll have to pay $1,350 out of your own pocket.
When your costs reach $3,600 you'll pay $2 for generic drugs and $5 for name brand drugs - or a 5% coinsurance fee, whichever is higher.
Each drug or Medicare Plan is different, so review plans carefully before you choose one. It's important to stay informed about all of the costs that you'll be responsible for paying.
Be Informed About Your Part D Drug Plan
Your Part D options can get confusing. The best way to make sure you are making the right decision is to get advice from an agent. With our free quote service, our professional agents can help you make an informed and educated decision.
