Medicare Part D
If you’re on Medicare, then Medicare Part D is your prescription drug insurance plan.
You can buy Medicare Part D one of two ways. If you select Original Medicare Part A and B, whether you have a Medicare Supplement plan or not, you would have to buy a separate drug plan, if you want drug coverage. Drug coverage isn’t provided by Medicare Supplement insurance plans.
If you select a Medicare Advantage plan as your Medicare coverage, then most of these plans will have the drug coverage included.
Depending on the medications you take, your drug costs could be either very little- or very significant. The cost of your medication is what it is and will be very close in cost, whether you get your Part D plan separate, or through a Medicare Advantage plan. If you join an advantage plan, then you’ll have to use the drug plan included with the plan and again, depending on your medications, may not be the least expensive for you.
If you stay away from Medicare Advantage and want to buy a Part D drug plan to go with your Medicare and your Supplement- you can actually select the drug plan that’s best for your situation. We simply input your medications and dosages into our system with Medicare- and it will display all the drug plans in your area- so we can see which will be best for your situation.
Medicare offers prescription drug coverage to everyone with Medicare. If you decide not to join a Medicare Prescription Drug Plan (Part D) when you’re first eligible, or if you decide not to join a Medicare Advantage Plan (Part C) (like an HMO or PPO) or other Medicare health plan that offers Medicare prescription drug coverage, you’ll likely pay a late enrollment penalty unless you have other creditable prescription drug coverage, or you get Extra Help.
- Part D plans must cover at least the Part D standard benefit or its actuarial equivalent.
- For 2017, the standard benefit requires the beneficiary to pay:
- $400 deductible
- 25% of prescription drug costs between $400 and $3700 = $825
- Part of the costs in the “Coverage Gap” – After total spending on drugs by the beneficiary, by certain subsidy programs and by the plan, reaches $3700 the beneficiary pays for 51% of generic drug costs and 40% of brand name drug undiscounted costs (drug manufacturers provide a 50% discount on brand name drugs).
- The amount beneficiaries pay while in the coverage gap decreases by a small percentage each year until 2020 when they will be responsible for only 25% of brand and generic drug costs.
- Nominal costs under catastrophic coverage: Once beneficiary expenditures (including drug manufacturer discounts) reach a total of $4,950, the beneficiary is through the coverage gap and reaches catastrophic coverage. On any future prescriptions the beneficiary pays either a co-pay of $3.30 for generic drugs or $8.25 for brand name drugs or a co-insurance of 5%, whichever is greater.
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