Medicare Part D, or Medicare Prescription Drug Coverage, is a program through Medicare that provides insurance coverage for prescription drugs. In general, Medicare can tend to be somewhat complicated, so in order to make an informed decision, there are a few important things you should know about Medicare Part D.
Anyone who is currently on Medicare is already eligible for Medicare Part D. There is no screening process for pre-existing conditions, and anyone of satisfactory eligibility is able to enroll and be accepted for the plan. For most people, Medicare D is a completely separate enrollment, even if you already are on Medicare.
Medicare Part D has many different plans for prescription drug coverage. A formulary, or a list of drugs that a plan will cover, is included with each Medicare Prescription Drug Plan. These lists will also tell you how much money you would potentially need to pay for specific drugs and advise you of any limitations. If the drug you need is not specified in your formulary, you will have to pay for the drug out of your own pocket. In order to avoid these fees, another potential solution might be finding a similar drug that the plan does cover. It is also possible that Medicare may make changes to your formulary, but they are required to give you sixty days notice if any adjustments are made.
Medicare.gov has a Prescription Drug Plan Finder, which is a tool to help you choose the plan best suited for your needs. You can type in the names of your drugs and pharmacy, and then compare the costs of different plans online.
You will want to make sure your prescriptions are filled at a pharmacy that is inside Medicare Part D’s network. If you were to use a pharmacy outside the network, you would most likely be charged a higher fee for your prescription drugs.
Your deductible, or the amount you need to pay before the plan kicks in, may be anywhere between $0 and $265.00, and usually averages about thirty-two dollars each month. In your decision making process, it is crucial to be aware that these amounts are changed each January in accordance with inflation. While the deductible you are paying in 2007 may be affordable, it could likely grow higher with each consecutive year. This may not be an issue of concern for those who are eligible for extra help due to low income.
It is also important to note that some plans may have a low deductible, but high premiums. In order to take advantage of the most savings, you will want to choose a plan with the lowest total yearly costs. To find the best plan, you must take into account all information about premiums, deductibles and co-payments.
When making decisions about your prescription drug coverage, you should be aware of a coverage gap, often referred to as a “donut hole” in the Medicare Part D plans. Those people whose total prescription drug costs end up being more than $2,400.00 annually will reach a coverage gap in their insurance. At this point, the beneficiary will be responsible to pay 100% of drug costs. (If these out-of-pocket costs surpass $3,850.00, Medicare Part D will cover 95% of additional costs for prescription drugs.) Some people in certain income brackets may be eligible for additional financial assistance, and will not have any gap in coverage.
In relation to this, one thing you should know is that you will be responsible to pay your monthly premiums even when you have reached the “donut hole”. These premiums are not considered “out of pocket” expenses.
There are certain plans that do not have any gap in coverage. However, these plans may end up costing you much more money because of what you pay in premiums, so, again, it is important to take into account the total cost of each plan before deciding.
There are few good tips for avoiding heavy expenses for prescription drugs. One is to contact your pharmacist for information on generic drugs that are much cheaper than standard brand-name drugs. Also, be sure to tell your doctor if you feel you cannot afford certain medications. Doctors usually have many samples that they can dispense for free. As well, it is important to alert them so they can prescribe the cheapest generic version of drugs as possible.
It is always an option to remain enrolled in your current retirement health care plan, as it is required that you be given information on how your plan compares with Medicare’s. However, if you plan on enrolling in Medicare Part D at any time, you will want to do it sooner rather than later to avoid paying penalties.
Those who are already on Medicare may enroll in Medicare Plan D any time between November 15, 2007 and December 31, 2007. Anyone who is not currently on Medicare may apply for Medicare Plan D three months before his/her sixty-fifth birthday. There is also an extension period of three months provided after one’s sixty-fifth birthday, in order to decide if the Medicare Prescription Drug plan is the right choice for the individual. If you do not enroll within this time bracket, your premiums will be raised one percent for every month you delay. In other words, if you wait two years to enroll in Medicare Part D, you will be paying 24% more than those who registered and enrolled within the six-month window. Because of these penalties, those who think they may potentially need the benefits of Medicare in the future might be wise to join earlier than medically necessary.
The process of understanding Medicare can sometimes feel like a maze. Before you make a final decision about whether Medicare Plan D is right for you, it would be a good idea to check into local Social Security office or office for the aging. These organizations may be able to give you valuable advice and help in the right direction so that you can make the best choice possible.
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