Medicare Part D offers prescription drug coverage.
Medicare Part D fills in the gaps of Parts A and B to cover prescription drug costs.
What is Medicare Part D?
Medicare Part D was established in 2003 as part of the Medicare Prescription Drug Improvement and Modernization Act, or MMA. Medicare began to cover prescription drugs under Part D in 2006.
Understanding Medicare Part D.
For more than 40 years, Medicare did not cover the cost of prescription drugs. Parts A and B still do not provide any coverage. Rather, those eligible for Medicare have two choices. They can buy a Medicare Advantage (Part C) plan that includes coverage for prescription drugs or they can buy Medicare Part D. If you are enrolled in Medicare Part A and/or B, and you do not have prescription drug coverage from any other source, you should consider enrolling in Medicare Part D. However, if you choose not to enroll when you’re first eligible and you do not have other creditable prescription drug coverage, you will be charged a penalty if you decide to enroll in Part D later.
How does Part D work?
There are various costs associated with Medicare Part D. Upon enrolling, you will pay a premium. This will be in addition to any premium you pay for Part B. Your premium will be higher if you are subject to the late enrollment penalty. Here are some reasons why you might want to choose this type of plan:
May lower the cost of prescription drugs.
Typically low cost and affordable.
The flexibility of choice in your plan.
Compatible with other types of Medicare.
Medicare Advantage Plans
How do these plans work?
These plans contract with Medicare and also follow the Medicare rules and regulations. They are also reimbursed by the United States government. These plans can charge different premiums, copays, and deductibles than Original Medicare, and these will often differ from plan to plan. The plans are provided through private insurance companies, which allows someone who has Parts A, B, and D to have all their coverage managed by one company.
Additional things to know
It is possible to buy an Advantage plan that does not include prescription drug coverage. If you enroll in one that does not, such as a Medical Savings Account plan or a fee-for-service plan, you can still enroll in a separate Part D plan. However, if your Advantage plan does offer prescription drug coverage and you enroll in a separate Part D plan, you’ll be disenrolled from your Advantage plan and be placed into Original Medicare.
Medicare Advantage and Supplement Plans
Advantage plans do not work with Medigap (Medicare Supplement Insurance) plans. Medigap plans are designed to cover out-of-pocket costs like deductibles, coinsurance, and copayments of Original Medicare. They cannot pay for the out-of-pocket costs of Advantage plans.
Medicare Consultation Request
If you’d like to explore your options with Medicare Advantage plans, contact us to learn more.
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