Medicare Part D is optional prescription coverage that can be added to Original Medicare. Here are the basics of how it works, what it costs, and how to choose a plan.
The Medicare Part D Plan is an optional prescription drug benefit that can be added to Original Medicare, some Medicare Cost Plans, and some Medicare Private Fee-for-Service Plans.
Medicare Part D is a voluntary prescription drug benefit that can be added to Original Medicare, some Medicare Cost Plans, and some Medicare Private Fee-for-Service Plans. If you are eligible for the plan and enroll in it, you will have coverage for your prescription drugs.
Medicare Part D is available to people who are eligible for Medicare (age 65 or older) and those under age 65 who qualify due to a disability or end-stage renal disease. However, it's not available if you have an Advantage Plan. These plans provide all of your health care benefits under one contract with a private company instead of using both Medicare and another insurance company.
The Medicare Part D coverage works to help pay for most outpatient prescription drugs.
The Medicare Part D coverage works to help pay for most outpatient prescription drugs. If your plan does not cover a medication, you may have to pay the entire cost of that prescription yourself. You can use our tool below to determine which drugs your plan covers and how much they would cost you at a participating pharmacy in Boise, Idaho.
How do you choose a plan?
So, how do you choose a plan? The easiest thing to do is to call us for help. But you can also go online. You can use the Medicare website and click on the “Compare Plans” button to get a list of all of your options. There are also apps for mobile phones and tablets that will make it easy for you to compare plans.
If that sounds too complicated or stressful, call us at (208) 818-2523, and we'll walk you through it. We're happy to help!
You can also call 1-800-MEDICARE (1-800-633-4227). This hotline has representatives available 24 hours per day who can help with enrollment questions in English or Spanish. Or you can go to Medicare.gov to review it online.
Another option would be to visit your local office or pharmacy, where they might have more information than what's on their website or in their app. Just ask them if they have any brochures about Medicare Part D plans available! They may also have someone who could answer some questions for free or even give advice based on what type of prescription drugs are most essential for you right now (for example, depression medication vs painkillers).
What are the costs of a Part D plan?
Medicare Part D plans are available through private insurers and the federal government. The costs of each plan vary depending on the insurer and plan you choose, but all Part D plans include a monthly premium, an annual deductible, copayments, and coinsurance.
Monthly Premium – You pay a fee to be enrolled in the plan every month. The amount varies depending on factors like your age and whether you're eligible for extra subsidies based on your income level or state of residence.
Annual Deductible – You must meet this yearly out-of-pocket expense before your insurance starts paying any benefits to cover prescription drugs covered under Medicare Part D coverage (with some exceptions). Your prescription drug plan may have different deductibles based on whether you have generic or brand name medications covered by them. The average annual deductible for 2018 was $405 per person across all types of drug plans offered by private insurers offering Medicare Advantage options with prescription drug coverage as part of their benefits package.
What if I don't have a Part D plan?
If you don’t have a Part D plan, you will have to pay the total cost of your prescriptions. You can purchase a stand-alone prescription drug plan (PDP), but this comes with an additional premium and out-of-pocket costs. Alternately, if you have Medigap coverage or Medicare Advantage coverage, either of these might help cover the cost of your prescriptions.
What should you do if you do not want to purchase a stand-alone prescription drug plan and are happy with your existing coverage options through Medicare Advantage or Medigap? First off, find out if there is an open enrollment period when changes can be made to your current policy or benefits. If there isn’t one right now or in the near future and you would like more information about how Medicare works before making any significant changes to your benefits package and premiums paid each month/year, then contact us today at 208-818-2523, so we can get started helping answer questions about how best meets needs going forward!
What about people in long-term care or nursing homes?
Medicare Part D does not cover drugs for people who are in long-term care or nursing homes. It also doesn't cover medications for people in assisted living facilities, hospices, and other settings that care for the elderly.
However, you can still get a Medicare Advantage plan that covers drugs if you live in one of these settings. Just like with a stand-alone Part D drug plan, all of your medical expenses will be covered as long as they're approved by Medicare and the cost isn't more than your deductible and coinsurance amounts (if there are any).
If you need assistance deciding on a Part D plan, contact us, and we will help you out!
If you need assistance deciding on a Part D plan, contact us, and we will help you out! We can help you figure out which plan is best for you. We can also help you determine what your costs will be and how to enroll in the plan that is right for your situation. If, at any time during enrollment or after completion of enrollment, there are changes to your health status or prescription medications that may affect coverage under your chosen Medicare Part D plan, we can also assist with making those changes possible as well!
We hope you've found this explanation of how Medicare Part D works helpful. However, please keep in mind that what we've covered here is a fundamental overview and doesn’t cover all the details, so if you have any questions or need more information, feel free to contact us. We would love to assist! Also, remember that costs and coverage can change at any time, so be sure to check each year during open enrollment for updates on your plan options before signing up again. That way, you can make an informed decision about which plan will work best for next year's needs!
About Preferred Senior Benefits in Meridian, Idaho
Medicare is a federal program that provides healthcare coverage to individuals 65 years or older. Original Medicare coverage is broken into two parts—Part A and Part B—and is accepted by nearly every doctor and hospital in the country. Medicare Part A covers inpatient or hospital stays, while Part B covers outpatient or medical care. Together, Part A and B cover about 80% of the typical healthcare costs seniors face. Unfortunately, this leaves a few significant gaps in coverage. Medicare Supplement (Medigap) and Medicare Advantage plans are policies designed to help extend range, lessen costs, and ultimately give beneficiaries peace of mind. If you or someone you know would like more information about how to enroll in Original Medicare or one of the Medicare Advantage plans, call now to speak with a licensed agent (208) 818-2523. We can’t wait to help you learn about your options.