Part D Medicare Coverage
When it comes to health care prescription benefits, many seniors are taking advantage of the new Medicare Part D plans that have become available since 2004. These plans allow seniors who do not have some kind of supplemental health care coverage for their medications to receive coverage that can reduce the amount you spend on your pills -- or even have your medications paid for altogether.
What Benefits Does Medicare Part D Provide?
Medicare Part D plans allow seniors to receive their prescription drugs at a reduced cost out of their own pockets. The plans allow common prescription medications to be covered in part or in full through the use of generics or name brand medications that are commonly prescribed to seniors. If the drugs fall into generally prescribed classes, Medicare Part D coverage kicks in.
For beneficiaries, the plan covers 75% of prescription costs above $250 per year. The recipient has to pay an initial deductible of $250, then one quarter of the costs from $250 to $2250. From $2250 to $5100 per year, the beneficiary pays for all of those costs out of pocket, and any costs above $5100 are completely covered by Part D insurance. This ensures beneficiaries who use expensive treatments will be covered for any extreme costs.
The insurance works to reduce the amount of out of pocket costs in concert with the other medical care provided by Medicare's other parts. The Part D plans are not provided directly by the government; as a result, the types of drugs covered can vary. Consequently, someone looking into Part D plans should shop around and find the plan that covers the drugs in their regimen.
Medicare Part D is the prescription drug program available to Medicare recipients that gives them several options to help pay for their medications. Each company that's part of it is privately-run and will vary from the next, but each meets the standards required by the government. It's an optional benefit and it will cost you a monthly fee if you take part.
Since each company's plan is different, there's a wide variety of drugs covered in Part D health insurance that can be good (or bad) depending what you require, so it's important to research before you pick one. Get a clear understanding before deciding so you do not face penalties for changing your mind later on, considering things like: 1) Do you already have drug coverage that Medicare considers "creditable coverage."; 2) What prescriptions are you taking and how much does each cost you each time you have them filled?; 3) Do you have a good grasp of the information in the "Medicare & You" pamphlet or details you found online?; and 4) which Part D plan best meets your needs and desires for specific drugs?
*You may be able to get extra help to pay for your prescription drug premiums and costs. To see if you qualify for getting extra help, call:
- 1-800-MEDICARE (1-800-633-4227). TTY/TDD users should call 1-877-486-2048, 24 hours a day/7 days a week;
- The Social Security Administration at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY/TDD users should call, 1-800-325-0778; or Your State Medicaid Office.