- Free Medigap Quote
- Medicare Supplement Plans
- ABC’s of Medicare
- Medicare Publications
- Part D (Drug Coverage)
- Guide to Medicare: Helping You Navigate the Medicare Maze
Medicare Part D is the part of Medicare that pays for prescription drug coverage. If you are eligible for Medicare, you can sign up for a Medicare Part D plan. There are several plans to choose from and it is each individual’s responsibility to sign up for the plan that is best for them.
Choosing a plan will depend on several different factors. The most important thing to consider will be the types of prescription medications you are already taking. You will want to be sure the medications you need, will be covered by the plan that you choose.
Each of the different Med D plans uses a formulary, or a list of medications they will or will not cover. Even if a specific drug is on the formulary, the cost to you will depend on which tier the drug falls in. Most drugs will fall into one of three tiers: generic, brand name and non-preferred.
Typically, generic drugs are the least expensive tier. Most plans will require you to use a generic drug if it is available. These medications have lower costs, therefore, lower co-pays.
Not all drugs are available in generic form. When your doctor prescribes a brand name drug, it will be available to you at the higher brand name co-pay. Depending on whether the medication is preferred or non-preferred will determine the exact cost to you.
There are other factors that will determine the cost of a particular medication. Some medications will be covered by the plan only if you have tried other cheaper alternatives, and your doctor decides that those medications will not work for you. In this case, the doctor has the option to call the insurance company and have the medication prior approved.
Yet another factor to consider when choosing a plan is the cost of premiums and deductibles. These costs will vary from plan to plan. Most plans will include a donut hole. This means that once a certain amount has been paid for the year by the insurance, you will be responsible for 100% of the cost until you have paid so much out of pocket, at which time the insurance company will once again pick up the cost of the medication.
The best way to choose a Medicare Part D plan that will work best for you is to take the time to do some research on each plan. You will have the option to change plans once a year if you find that the plan you have is no longer beneficial to you. The Medicare.gov web site has a great guide to help you find the best prescription drug coverage for your needs. You can enter in your prescriptions and your location. They will find the best plan with the best coverages for your existing prescriptions.