Medicare Part D

What is Medicare Part D?

Part D of Medicare is insurance for your prescription drug needs. These plans are offered through private insurance companies and can be purchased as a stand-alone option with Original Medicare or in conjunction with a Medicare Supplement Plan.  Many Medicare Advantage plans include prescription drugs. Keep in mind that there can be a Part D premium penalty for late enrollment.

Things to consider when choosing a Part D plan include:

• Costs; what’s the monthly premium?
• Are my drugs covered?
• How much will my medications cost?
• Are there deductibles that will apply?
• Which pharmacy can I use?
• Formulary structure: in general, the lower the tier, the lower your cost for the drug will be.

Is Medicare Part D right for me?

Deciding which Medicare Part D plan is the right choice for you depends largely on your current prescriptions, the pharmacies that you can use and of course the cost of your drugs. Choosing the right Medicare Part D plan can help you with your monthly medication costs and is something you should review annually as coverage and costs are subject to change year-over-year.

Many Medicare Advantage Plans include Part D coverage at no additional cost.  Because joining a Medicare Advantage plan with Part D may affect your current coverage it is important to understand the impact that enrolling in a Part D plan will have on your current Medicare coverage.  Part D plans can also be purchased as a stand-alone option in conjunction with Original Medicare or a Medicare Supplement (Medigap) plan. Generally, you can only have one Medicare Part D plan at a time.

What if I didn’t need Medicare Part D when I enrolled, but now I do?

Medicare may charge you a Late Enrollment Penalty (LEP) for not having Part D coverage for longer than 63 days in a row after your Initial Enrollment Period. Like all rules, there are some exceptions. People that have creditable prescription drug coverage from a current or former employer or union, TRICARE, the VA, CHAMPVA, or health insurance coverage may be exempt.

Here are some ways to avoid the Part D late enrollment penalty:

• Join a Medicare drug plan when you’re first eligible.
• Don’t go 63 days or more in a row without Medicare prescription drug coverage or other creditable drug coverage.
• Keep records showing when you had creditable drug coverage, and tell your plan about.

An Annual Review Can Help You Update Your Plan

An annual review of your Medicare coverage can save you money, time and may prevent problems with your coverage. Each year, Medicare plans are subject to change. This can take the form of premium increases (or decreases), formulary and network (provider) changes. We recommend meeting with your independent insurance agent annually to review your current coverage and changes for the upcoming coverage year.

Important things to consider:

• Have my health needs changed?
• Are the doctors and hospitals that I prefer still in the network?
• Did the formulary change?
  • Are my drugs still on the same tier?