Medicare Part D
A Florida Medicare supplement insurance broker will guide you through all the steps so you can have the peace of mind that you took care of this important facet of your health coverage efficiently and thoroughly.
Medicare Part D is also referred to as the Medicare prescription drug benefit. Even though these drug plans are purchased from private insurance companies such as Silverscript, United or Humana, it’s actually a federal program that subsidizes the cost of those prescription drugs as well as the prescription plan monthly premium. It was placed into law when the Medicare Modernization Act was passed in 2003.
Individuals on Medicare are eligible for prescription drug coverage or Part D but must be signed up for Medicare Part A and/or Part B. It’s important to know that drug plans differ in a number of ways. The monthly premium can vary from one drug plan to the next, monthly copays for medications can vary quite a bit and which drugs are actually covered can vary from one plan to the next.
You can only enroll into a drug plan during various specified enrollment periods. The most common period to enroll is when you first become eligible for Medicare at 65 years of age. This is called the Initial enrollment period. You can also change your drug plan every year during the annual enrollment period which always takes place from October 15th to December 7th. The effective date is always January 1st. On January 1st, the calendar year deductible, if there is one, resets. If you do decide to change drug plans, the last plan to be applied for, will be the one that becomes effective. There’s never a need to call and cancel a drug plan unless you absolutely do not want any drug coverage whatsoever.
If you do not enroll into a Part D drug plan when you are first eligible, you will end up paying a late-enrollment penalty. This penalty is 1% per month of the national average cost of a drug plan. Multiply this by the number of months you went without drug coverage. This is then added to your monthly premium and is a penalty that you will have to pay indefinitely. So, there’s a lot of incentive to sign up for some kind of drug plan (even the lowest cost one) simply to avoid this penalty later on.
There is also extra help to pay for drug plans if you qualify financially. Best way to find out is visit the Social Security website and search: Low income subsidy for prescription drug plans.
Joining a drug plan is relatively easy. You can go directly to the Medicare website and join from there. However, that can be a difficult task to navigate and the fine print at the end can be confusing when attempting to determine which drugs are excluded or have quantity limits. Perhaps the easiest way to get the best value and best fit drug plan for your needs is to have a careful conversation with an independent licensed agent who is appointed to help people enroll into these Part D plans. An independent agent can compare a few popular plans and research all of your medications to make sure they are all covered.
You can make changes to your Medicare prescription drug coverage when certain events happen in your life, like if you move or if you lose other insurance coverage. This is referred to as a special enrollment period, also called a SEP. Common reasons for a special enrollment period include: Changing where you live; (it does have to be a different service area such as moving to a new state). Losing employer sponsored group coverage is another very common SEP.
There is also help for those who have extraordinarily expensive drugs. Check the resource page on this website for links to non-profit organizations that help those with high cost medications.
Lastly, it’s important to know that if your income is above a certain threshold, you can end up paying more than the standard monthly premium for your drug plan. You can contact the agent or agency below to obtain more information about rules for higher income beneficiaries or go to https://www.medicare.gov/part-d/costs/premiums/drug-plan-premiums.html for more info.