Learn About Medicare Part D
What is Medicare Part D?
Medicare Part D is prescription drug insurance coverage that began January 1, 2006, for those who are eligible under Medicare. The coverage is not available directly from Medicare but is provided through private health insurance companies. Health plans have contracted with Medicare to provide this coverage to beneficiaries.
Who is Eligible?
Everyone with Medicare is eligible to join a Prescription Drug Plan (PDP), regardless of income, health status or how much you currently spend on prescription medicines. You must be entitled to the Medicare benefits under Medicare Part A and/or enrolled in Part B to be eligible for Part D.
From November 15, 2007, through December 31, 2007, everyone currently enrolled in a Medicare PDP is eligible to enroll in plans for coverage to begin on January 1, 2008. Those covered under Medicaid and Medicare can switch each month. People turning 65 years old, who are eligible for Medicare, can join a PDP as soon as three months before and as late as three months after their 65th birthday.
The plan you choose should depend on how much you want to pay each month for coverage (your premium), how much you want to pay out of pocket for medicines before coverage kicks in (your deductible), how much you want to pay at the pharmacy for each prescription (your co-pay or coinsurance) and which plan(s) cover the drugs you are taking.
To get Medicare coverage for your prescription drugs, you must choose and join a Medicare drug plan.
How to Choose a Plan
There are four things you need to consider before choosing a plan:
- Your cost
- Whether your drugs, a generic equivalent or substitute are covered
- Whether the pharmacies you use are included
- What your needs may be in the future
Important Things You Need to Know
When you consider the cost of your plan, you should not only look at the amount you pay each month (your premium) but also the amount you’ll pay before your plan starts to share in your costs (your deductible).
Equally important is the amount that you’ll pay for your medicines, after you have paid the deductible (your co-pay or coinsurance). Different plans have different costs, and not all plans have a deductible.
You also should check to be sure the plan covers the medicines you take most often. To do this, look at the plan’s formulary list or call customer service. If you take a lot of expensive prescriptions, you might want to buy a plan that gives you some coverage, such as generics coverage, in the gap. Also, check to see what plans allow you to go to your regular pharmacy or one near you.
Maybe you don’t take many prescriptions now, but it is difficult to know what will happen in the future. If you join a Medicare drug plan now, you may pay a lower monthly premium than if you wait to join.