Guide to Medicare Part D - Prescription Drug Coverage

Guide to Medicare Part D We're talking here about Part D of Medicare and the first fact you need to understand is that in order to have the cost of your prescription medications partially covered you must enroll in a government-approved Medicare drug plan. You can choose either a Medicare Advantage Plan (Part C) or a Medicare Prescription Drug Plan. If you only have Part A (hospital insurance, free) and Part B (medical services and supplies, nominal premium), you will have to pay all your drug costs out of pocket.

Warning! If already have a Medicare Advantage Plan and you enroll in a Medicare Prescription Drug Plan, you will be dropped from your Advantage plan and returned to original Medicare A and B. This would strip you of the benefits beyond prescription coverage offered by most Advantage plan such as vision and dental care. Remember, many of the best Medicare Advantage plans are free to you because the government pays the plans. Don't risk losing your plan by making the mistake of thinking you should also enroll in a Medicare Prescription Drug Plan. Not only is your Advantage Plan likely offer an array of extra benefits, but you will also pay very little for each prescription – as low as $6 a month depending on the drug.

Here Are the Details About Prescription Drug Coverage (Part 1) Plans vary as to what drugs are covered. Be sure to consult the "formulary" -- the list of drugs covered – for each plan you're considering to find out whether your needs will be met. The government mandates the types of drugs that must be covered but you may not be able to get specific brands or you may have to accept generic versions if you enroll in certain plans.

Part 2 When you’re first eligible for Medicare, you can join during the period that begins 3 months before the month you turn 65 and ends 3 months after the month you turn 65.

Part 3 You can join either of the Medicare drug plans between October 15th and December 7th. You can also switch or drop plans during that time period. Changes will take place on January 1st 2012.

Part 4 You have to stay enrolled for the full calendar year unless you move out of your plan’s service area, lose other prescription drug coverage, or live in a nursing home.

Part 5 You can enroll in either type of Medicare drug plan online at How to Join a Medicare Drug Plan at Medicare.gov. You could also fill-out a paper application, or call the plan of your choice, or call 1-800-MEDICARE.

Part 6 Most Medicare drug plans have a coverage gap that has been dubbed the “donut hole." When you reach a certain dollar amount for drug costs, there will be a temporary limit on what the drug plan will cover. If you don't have a lot of prescriptions, you probably won't fall into the gap. If you do, you get a 50% discount on covered brand-name drugs. The manufacturer covers these costs. However, you'll get credit as though you were paying full price and this will get you out of the gap more quickly. You’ll also save 7% of the plan’s cost for all generic drugs until you get out of the gap.

Part 7 When you do get out of the coverage gap, you'll automatically receive catastrophic coverage that assures you'll pay only a nominal amount of coinsurance for covered drugs for the rest of the year.