Medicare Part D
Medicare Part D is simply insurance for your medication needs. You pay a monthly premium to an insurance carrier for your Part D plan. In return, you use the insurance carrier’s network of pharmacies to purchase your prescription medications. … Your Part D insurance card will be separate from your Medigap plan. Medicare Part D is the prescription drug benefit offered through insurance companies as either a stand-alone plan or beneficiaries can choose a Medicare Advantage plan that also features prescription drug coverage
What does Medicare Part D cover?
Each plan that offers prescription drug coverage through Medicare Part D must give at least a standard level of coverage set by Medicare. Plans can vary the list of prescription drugs they cover (called a formulary) and how they place drugs into different “tiers” on their formularies. If the drug you need is not on the formulary, you are allowed to request an exception, pay out of pocket, or file an appeal.
These formularies differ from plan to plan so be sure to request a copy. However, each plan must cover all drugs in the following categories:
⦁ HIV/AIDS treatment
⦁ Antipsychotic medications
⦁ Anticonvulsive treatments for seizure disorders
⦁ Anticancer drugs (unless they are being covered under Part B)
Most vaccines are also covered under Part D unless they are already covered under Part B.
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How much does Part D cost?
Monthly premiums and copays differ from plan to plan. However, as discussed earlier, each plan has a formulary that lists different drugs that are covered. So, the cheapest plan may not always be the best choice. Be sure to speak with a licensed Medicare agent at USAmeriCare to double check the plan you are interested in and that it will cover all of your drugs.
How do I enroll in prescription drug coverage?
You can enroll in a Medicare Part D plan during one of the three enrollment periods. After choosing the prescription drug plan that is right for you, you can enroll as you turn 65 years old (Initial Enrollment Period, or IEP), during the Annual Enrollment Period (AEP) between October 15th through December 7th, or during a Special Enrollment Period (SEP). Some Medicare Advantage plans also include Part D coverage. Again, if this is how you would like to receive your prescription drug coverage, make sure it covers all the drugs you require.
You can enroll in Medicare Part D when you enroll in Original Medicare.
This is the three months before you turn 65 and the three months after your 65th birthday.
There is also an annual election period from October 15 through December 7 in which you can enroll or disenroll from any drug plan.
The insurance company with which you have your plan will mail you an Annual Notice of Change each September. This letter will detail all changes coming with your plan so you can decide if you would like to make a change.
If you wish to keep your current coverage, you don’t have to do a thing. It will automatically renew in January.
Avoiding the Part D Late Enrollment Penalty
One thing to remember when preparing to enroll in a Part D plan is the Part D Late Enrollment Penalty (LEP). This penalty makes enrolling during the proper enrollment period crucial. You may pay a monthly Part D Late Enrollment Penalty assessed by Medicare if all of the following hold true prior to enrollment.
⦁ You went longer than 63 days without creditable prescription drug coverage (as good as Medicare’s).
⦁ The 63 days without creditable coverage was after the end of your Initial Enrollment Period (IEP). In other words, you went 63 days or more after three months past your 65th birthday without coverage⦁ 1.
⦁ You did not have creditable coverage after your IEP ended.