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What Does Medicare Part D Cover?
Medicare offers a prescription drug coverage option to everyone enrolled with Medicare called Part D. You should enroll in Part D when you first become eligible. If you choose not to get Medicare drug coverage when you’re first eligible, you’ll likely have to pay a late enrollment penalty eventually whenever you do enroll unless one of these applies:
- You have other creditable prescription drug coverage
- You receive what’s called “Extra Help” for medicare prescription drugs costs.
To get Medicare Part D drug coverage, you must join a plan run by a private insurance carrier or other private company approved by Medicare. Each plan can vary in cost and what drugs are covered by their formulary.
There two (2) ways to get Part D drug coverage
- Medicare Prescription Drug Plan (Part D). These plans (sometimes called “PDPs”) add drug coverage to Original Medicare, some Medicare Cost Plans, Medicare Medical Savings Account (MSA), Plans and Medicare Private Fee-for-Service (PFFS) Plans.
- Medicare Advantage Plan (Part C)(like an HMO or PPO) or other Medicare health plan that offers Medicare prescription drug coverage. You get all of your Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage, and prescription drug coverage (Part D), through these plans. Medicare Advantage Plans with prescription drug coverage are sometimes called “MA-PDs.” You must have Part A and Part B to join a Medicare Advantage Plan.
How to join a Part D Prescription drug plan ?
Once you decide on a certain Medicare drug plan, here’s how you may be able to enroll:
- Enroll on the Medicare Plan Finderor on the plan’s website.
- Complete a paper enrollment form with our licensed agent
- Call the insurance carrier offering the Part D insurance plan.
- Call Medicare at 1-800-MEDICARE (1-800-633-4227).
When you join a Medicare drug plan, you’ll give your Medicare Number and the date your Part A and/or Part B coverage started. This information is on your Medicare card.
Consider all your Prescription drug coverage choices
Before you make a decision, learn how Part D works with other drug coverage that you currently have . For example, lets say you may have prescription drug coverage from an employer or union, TRICARE, the Department of Veterans Affairs (VA), the Indian Health Service, or a Medicare Supplement Insurance (Medigap) policy. Compare your current coverage to Medicare drug coverage. If you have what’s called “creditable coverage” or coverage that’s as good as Medicare’s you may not need to enroll in a Part D plan. However if you decide to enroll in Medicare Part D the drug coverage you already have may change because of the Medicare drug coverage, so make sure to consider all your coverage options.
If you have (or are eligible for) other types of drug coverage, read Evidence of Coverage document all the other materials you get from your insurer or plan provider. Make sure to talk with your benefits administrator, insurer, or plan provider before you make any changes to your current coverage
Joining a Medicare drug plan may affect your Medicare Advantage Plan
- Your Medicare Advantage Plan includes Part D prescription drug coverage.
- You join a standalone Medicare Prescription Drug Plan (Part D).
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