What is medicare Part D?
Part D is a prescription drug plan that helps you pay for your medications. Part D is optional and you are not required to enroll. However, if you join you may lower your costs and along with a supplement plan, it can help protect against higher costs in case of a catastrophic illness. There are over 40 plans available, and the plan that you choose will depend on your health, where you live, and other factors.
Not everyone needs or wants a Part D plan, but if you expect to use prescription drugs significantly in the coming year, it could be a good choice. If you don’t have creditable coverage when you’re first eligible for Part D and you go 63 days or more without it, you’ll face a penalty when you do sign up later.
Coverage and cost.
The plans offered through Medicare Part D have an annual deductible, which means that you must pay the full cost of your prescriptions until you have met your yearly deductible. Once you have met your deductible, you will pay a co-payment for each prescription; these co-payments vary depending on the plan in which you enroll. Some plans may also charge a monthly premium to help offset the costs of providing coverage to you.
The cost of your drugs usually changes each year, but not always at the same rate as your premiums.
The amount of prescription drug coverage you get and how much it costs depends on which plan you choose. Every plan offers at least some level of coverage for a wide range of drugs, but there are substantial differences from one plan to another. For example, some plans may not cover certain drugs at all while others offer full coverage with no copayment required. Typically plans charge higher copayments for brand-name drugs than generics, but this varies.
When Can You Change Part D Plans?
You can change from one Part D plan to another during the Medicare open enrollment period, which runs from October 15 to December 7 each year. This is also the time when you can switch from original Medicare to a Medicare Advantage Plan (Part C), or vice versa.
If you don’t sign up for Medicare Part D when you’re first eligible, you’ll have to wait until the next annual enrollment period, which begins on October 15 and runs through December 7 of each year. In most cases, you will have to pay a late enrollment penalty if you enroll after your initial eligibility period ends.
Late Penalty
Original Medicare, Part A, and Part B don’t cover most prescription drugs you take at home. Enrolling in a Part D plan — called “creditable coverage” — is important to avoid late-enrollment penalties.
Not everyone needs or wants a Part D plan, but if you expect to use prescription drugs significantly in the coming year, it could be a good choice. If you don’t have creditable coverage when you’re first eligible for Part D and you go 63 days or more without it, you’ll face a penalty when you do sign up later.
The penalty is generally 1 percent of the national average premium for each month you went without creditable coverage.
Medicare Advantage
The Medicare Advantage Plan is an alternative to standard Medicare. Most Medicare Advantage plans include prescription drug coverage. This can be an excellent simplification of your needs with only one plan to worry about. However, if you’re considering a Medicare Advantage plan and are on prescription drugs, be sure to compare both Part D and the overall plan for your needs.
Which Medicare Part D is right for me?
If you’re already getting Medicare, you should look into Part D coverage. It may give you more ways to save on the drugs that your doctor prescribes for you, and it could lower your overall health costs. From a financial standpoint, usually means the addition of costs to your healthcare budget. But this doesn’t mean that it isn’t worth it—many seniors can actually save money with Medicare Part D.
When it comes to choosing between Medicare plans, your health and well-being must be your first priority. Choose the plan that offers you the best coverage while still keeping within your budget. If you have reached retirement age and are ready to enroll in a Medicare plan, make sure to go over all of the plans in detail so that you can compare them effectively. Call Colangelo Group at (914)633-3333 to learn more about which Medicare plans may be right for you and/or your loved one.
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