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Medicare Part D

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WHAT IS MEDICARE PART D?

Medicare Part D is prescription drug coverage.  Part D covers prescription drugs, and is provided by private insurance companies that are approved by Medicare. You must have Medicare Part A or Part B to join a Medicare Part D Prescription Drug plan.

 

 

What Does a PDP Cover?

Each Medicare Prescription Drug Plan will have its own formulary, list of drugs covered by the plan. The drugs are sorted into different “tiers”, which are levels, and each tier group will have a different cost. Generally, medications in a lower tier will cost less than a medication in a higher tier.

 

There are two ways to add prescription drug coverage under Medicare:

Medicare Prescription Drug Plans, PDPs

PDPs are individual plans that add prescription coverage to Original Medicare, Medigap plans, some Medicare Cost Plans, some Medicare Private Fee-for-Service (PFFS) plans, and Medicare Medical Savings Account (MSA) plans; or,

Medicare Advantage Plans

Medicare Advantage (Medicare Part C) HMOs, PPOs, and other Medicare Advantage health plans also offer Medicare prescription drug coverage. Medicare Advantage Plans with prescription drug coverage are called “MA-PDs”. You must have Medicare Part A and Part B to join a Medicare Advantage plan, and not all Medicare Advantage plans offer drug coverage.

 

What Does Medicare Part D Cover?

Each Medicare Prescription Drug Plan will have its own formulary, list of drugs covered by the plan. The drugs are sorted into different “tiers”, which are levels, and each tier group will have a different cost. Generally, medications in a lower tier will cost less than a medication in a higher tier.

 

When Should I Apply For Medicare Part D?

 

  • Initial Enrollment Period (IEP):

The 3 months prior to the month you turn 65, the month of your 65th birthday, and the 3 months after.
During the three months before, to three months after, your 25th month of disability.
You can choose a stand-alone Prescription Drug Plan or a Medicare Advantage Drug Plans

  • Annual Enrollment Period (AEP) 

Between October 15 and December 7 each year and have your coverage effective as of January 1.

  • Medicare Advantage Disenrollment Period (MADP)
January 1st through Feb 14th, if you drop your  MADP and return to Original Medicare
  • General Enrollment Period 

If you already have Medicare Part A coverage, and receive Medicare Part B for the first time, you may also join a Part D Medicare Prescription Drug Plan

  • Special Election Period - Certain circumstances approved by Medicare
  • Within two full months of losing Creditable Coverage

TRUSTED TIP: If you decide not to join when you are first eligible you will likely pay a late enrollment penalty (higher premiums) if you join later. To avoid a Part D penalty, you must carry Creditable Coverage.Should a penalty be imposed, you will be responsible for paying that penalty for the entire time you have Medicare.

  

Trusted Senior Specialists can help you apply, please call Mon-Fri (8AM-8PM CST)

>>>>>>>>   855-474-6234  <<<<<<<<

 

How Are The Cost Associated with Medicare Part D?

Most Medicare Part D plans charge a monthly premium that varies by plan carrier. If you’re enrolled in a Medicare Advantage Plan, or a Medicare Cost Plan that includes Medicare prescription drug coverage, your prescription drug coverage will most likely be included in your monthly premium, and in some Part C plan, there will not be a premium.

Some Part D plans also have a annual deductible. The amounts you must pay for copayments or coinsurance for your covered prescriptions may also vary. Most Medicare drug plans also have a coverage gap that begins after you and your drug plan have spent a certain amount.

Social Security may determine that you must pay an extra amount in addition to your plan premium, if your income is higher ($85,000 if you file individually or $170,000 if you’re married and file jointly for 2017). This is known as IRMAA, Income Related Monthly Adjustment Amount.

 

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