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Understanding Medicare Part D |
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Medicare Coverage Part D is the name for the prescription drug benefit plan that is offered through Medicare.
Sifting through all the choices to find a plan that suits the needs of you and your family within the financial
constraints you have is not an easy task.
Understanding a few of the terms and conditions can help to simplify this undertaking and determine which option will best suit you and your dependents when you need it. Eligibility Anyone who has, or is eligible for Medicare Part A or B, is also eligible for Part D. If you have Part A you are still eligible for drug coverage even if you have never had Part B or if you had Part B and withdrew from it. There are no pre-screening tests that will make you ineligible. If you will be 65 years old by July 1, 2009, you can enrol for Part D during the 3 months before or after your birthday. If you qualify for Medicare and Medicaid, you will be automatically covered for prescriptions, but you will be assigned to a drug plan. If you want to choose your own, you will need to contact Medicare. Late Enrolment Fees Enrolment in Part D is voluntary; however, if you choose not to enrol during the eligibility period, a fee will be charged to you for enrolling after the sign up period. If you suffer financial hardship, you may qualify for assistance. If you are covered under another drug plan now, but it ceases at some point in the future, the late fee may be waived at the time of Part D enrolment. Existing Drug Plans and Part D You will need to call your employer to determine if your current plan is more comprehensive than the Part D coverage. In many cases, signing up for Part D may cancel your current coverage. Most employer plans include other benefits such as hospital care, dependent coverage and medical supplies. These plans will not allow you to separate their drug coverage from the rest of the plan. Once you cancel your employer plan, you may not be able to enrol again, so please make sure you understand the extent of your current coverage and the conditions that apply to it. Choosing a Plan Making an important decision should be based on an accurate look at the facts. You need to know what drugs you use, the pharmacy they are dispensed from, and the overall cost of the plan you like. You will need to decide between prescription-only coverage and the Medicare Advantage plan which also covers other medical benefits. Look for plans that cover your drugs for the least amount of money. Do your research; consult Medicare.gov to help you clarify the total the cost of your prescription needs. The total annual cost of your share of the prescription, plus the cost of the plan should be your bottom line. Once you narrow it down to 2 or 3 options, call each one and ask questions. Imagine scenarios where you will need to purchase a prescription and ask if it will be covered. Inquire if the plan covers generic versions of the brand name. If you travel a lot, find out how your coverage will work when you are not accessible to your local pharmacy. If your annual income is less than 20,000.00 and you have dependents, you may be eligible for financial assistance. Enrolling for Part D Coverage The window is open between November 15 and December 31 annually. Establishing your coverage during this period will get you a drug plan that becomes effective January 1 of the immediate year. If you are not happy with your plan, you can switch it during the November 15 and December 31 window each year. |