Basics and plan overview of Medicare Part D

Basics and plan overview of Medicare Part D

If you’re looking to improve your coverage in health insurance, Medicare Part D plans can be of immense value. These plans offset outpatient medication prescriptions, so you can save better through your insurance. Part D is offered by private companies either for people enrolled in Original Medicare, as a separate plan or as a special benefit with the Medicare Advantage Plan. There are several factors to consider before signing up for a Part D plan. These include pricing, ratings, coverage, and extra benefits. Read on to know more about Medicare Part D plans in detail.

  • What do Part D plans cover?
    Medicare Part D plans cover different types of prescriptions, including medication for HIV or cancer. The medications covered are compiled into a list called a formulary. It includes all medications, vaccines, and injectables. A formulary is also divided into different tiers. While the first tier includes generic affordable medications, the last tier comprises specialty expensive medications. Every plan must include at least two commonly used prescriptions in their formularies. If you find that your plan doesn’t cover the prescriptions you generally use, you can consult your doctor and ask to make an exception.
  • Deductibles and copayments

Deductibles are the price you pay annually for services covered in the plan. Medicare prescription plans usually have a yearly deductible, some charging in the range of $300 to $400. But there are a few plans that may not charge a deductible at all. Other than deductibles, you will also have to pay for copayments. Copays are predetermined amounts that are paid after one has paid the deductibles. This is usually a set minimum price you have to pay when you pick up your prescriptions.

  • Choosing a plan

With private companies offering different plans, it may be difficult to narrow down to one that suits you best. Compare plans to choose the one that best suits your needs. Look at plans as per good coverage, prices, and benefits, and pick one that checks all three boxes. Making the right choice also depends on your enrollment in an existing plan. For instance, if you are enrolled in the Medicare Advantage plan, prescriptions are often covered in the premium rates of the plan. However, premiums are not the only price you’ll be paying. You will also need to pay yearly deductibles and copayments for certain medications. Remember to check all these different terms before you opt for a Part D Plan.

  • Sign up

Sign up for a Part D plan within the enrollment period. You are eligible to sign up three months before, after, or during the month you turn 65. You may also be newly eligible for Medicare Part D because of a qualifying disability. In such cases, you are eligible to sign up three months before or after the month you claim disability.

  • Penalty

If you fail to sign up during the mentioned time frame, you will have to bear two consequences. Firstly, you will only be able to sign up in the open enrollment period, which is from October 15th to December 7th, with your plan kicking in on January 1st. Secondly, you will also have to pay penalties because of late enrollment. The penalty will be determined according to the time period you were without Medicare Part D since you were the least eligible. You will also have to pay the penalty price in premiums for all years to follow.

Savings through Part D

The money you’ll save through a Part D plan depends on variables like location, provider, coverage, and cost of medications covered. The latter part is crucial because it can make all the difference when it comes to saving on your Part D plan. Medications may range from $50 to $500 dollars. Having expensive medications included in your coverage prevents you from spending additional money on them other than the applicable copayments. Also, check for differences in costs in terms of premiums. Few companies may charge zero to $100 per month in premiums. So, to save more, remember to thoroughly go through the plan’s premiums, copayments, and deductibles.