What is Medicare Part D and What Does is Cover?
August 16, 2019 | Tom Peterson
There are a lot of questions regarding Medicare and its parts. Is Medicare Part D optional? What does Medicare Part D cover? If you have any of these questions concerning Medicare Part D prescription drug coverage, we’ve got answers!
What is Medicare Part D?
Medicare prescription drug coverage is an optional benefit offered to anyone who has Medicare. Part D plans are available for purchase by private insurance companies. A Medicare Part D plan provides coverage of Medicare approved drugs that are prescribed by your doctor.
If you decide not to get a Part D plan when first eligible a late enrollment penalty will be incurred. The penalty will only occur if you decide to join a Part D plan later.
What Does Part D Cover?
Each Medicare drug plan (Part D) must give at least a standard level of coverage that is set by Medicare. Keep in mind that plans can vary the list of prescription drugs that they cover (this list is called a formulary). Plans can cover both brand-name and generic prescription drugs and the formulary includes at least two drugs in the most commonly prescribed classes and categories. All Medicare drug plans must cover at least two drugs per drug category; however plans can choose which drugs they cover. Remember that the formulary (the list of prescription drugs that are covered) might not include the drug you need, but generally, a similar drug may be available.
How to obtain Part D Coverage?
Medicare prescription drug coverage (Part D) is provided by private insurance companies. Part D coverage may be included in a plan, such as a Medicare Advantage plan (MAPD). Medicare prescription drug coverage is also available as a stand-alone Prescription Drug Plan (PDP). These plans add drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private Fee-for-Service (PFFS) Plans, and Medicare Medical Savings Account (MSA) Plans. There are guidelines and limitations on when and how to enroll in each type of plan.
How Does Part D Work With Other Coverage?
It’s important to learn how prescription drug coverage works with other drug coverage you may receive. For instance, if you have drug coverage from TRICARE, the Department of Veterans Affairs (VA), an employer or union, the Indian health service, or a Medigap policy, compare your current coverage to Medicare Part D drug coverage. If you currently have other types of coverage, carefully read through any materials that you receive from your insurer or plan provider.
If you have questions about prescription drug plans (Part D), enrollment guidelines and various plan offerings, our Medicare team is here to help. Call us at 651-444-1190 or contact us online with any questions you may have.
References:
https://www.twincityunderwriters.com/medicare/medicare-made-easy-infographic/ https://www.medicare.gov/drug-coverage-part-d/what-drug-plans-cover https://www.medicare.gov/drug-coverage-part-d/how-to-get-prescription-drug-coverage