Medicare Part D
Medicare Part D (Prescription Drug) plan is a part of the government’s Medicare program, which is offered and managed by private insurance companies. This plan helps pay for medications not covered by Original Medicare. Medicare beneficiaries can decide to enroll in either a Medicare Advantage prescription drug plan (MA-PD) that covers all Medicare benefits or stand-alone prescription drug plan (PDP) to Supplement Original Medicare.
Drugs Covered by Medicare Part D
The prescription drugs covered by Part D plans usually vary depending on what each insurance carrier covers. Generally, Part D covers at least two drugs from every prescription drug category. Medicare Part D plans are also required to cover almost every drug class, including Antipsychotics, Antidepressants, Anticonvulsants, Immunosuppressants, Cancer drugs, and HIV/AIDS drugs. However, it is important to know that Medicare Part D doesn’t cover prescription vitamins, over-the-counter medications, and other certain medications.
Medicare Part D Eligibility
- Be at least 65 years old
- Received SSD payments for at least 24 months. However, this waiting period does not apply to those who receive a diagnosis of Amyotrophic Lateral Sclerosis (ALS) as they will be eligible starting from the first month of receiving disability payment.
- Be diagnosed with End-Stage Renal Disease (ESRD) and have at least one parent eligible for Social Security benefits.
Medicare Part D Enrollment
Most people are eligible to sign up for Medicare Plan D during the 7-month window surrounding their 65th birthday – the three months before they turn 65, their birthday month, and the three months after their 65th birthday. After this period, those who want to change their Medicare Plan D will have to wait until the Medicare Open Enrollment period. This starts from October 15 to December 7 every year.
However, beneficiaries that don’t sign up for Medicare Plan D when they sign up to get Medicare could face a penalty. Those that go more than 63 days without this plan are usually charged a late enrollment fee. The fee keeps increasing for every month the beneficiary is uninsured.
Cost of Medicare Part D
The cost of Medicare Part D is similar to those found with a prescription or standard medical insurance coverage plan. These Medicare Part D costs include premiums, copays, and yearly deductibles. The actual costs vary depending on several factors, such as the specific Medicare Part D plan they choose, the pharmacy they select, the medications they use, and more.
Medicare beneficiaries must continue to pay Medicare Part B premiums, and they may have to pay for an additional premium for the coverage of their Medicare Part D. Those that choose a Medicare Advantage Plan that already has drug coverage will have a premium that includes the drug and medical part of the plan.
If you need help with your Medicare Part D plan, you can contact us. At Senior Insurance Sales, our experts are available to help you choose the right plan for your health needs.