Medicare Drug Coverage Explained


Medicare Drug Coverage Explained

Medicare Drug Coverage Explained

Medicare drug coverage, commonly referred to as Medicare Part D, helps individuals over the age of 65 to pay for their prescription medications. It is highly recommended that even if you do not require prescription medication, that you sign up for Medicare insurance and a Medicare drug plan, even though drug coverage is optional.

Unfortunately, if you do not opt for the drug coverage during the time of Medicare open enrollment, you will likely pay a late enrollment fee later. To make matters worse, you will be charged this penalty for as long as you have drug coverage through Medicare in the future. Therefore, it is far more cost-effective to sign up for Part D coverage when you enroll in Medicare Parts A (hospital insurance) and B (medical insurance).

How Do I Get Medicare Drug Coverage?

There are two ways to get Medicare drug coverage. The first is through a Medicare drug plan, which can add coverage to your Original Medicare plan, Medicare Cost Plans, Private Fee-for-Service Plans, and Medical Savings Account plan. However, you must have Medicare Part A and/or Part B to get the add-on drug plan.

The other option is to sign up for Medicare Advantage Plan (Part C) or for another Medicare health plan that provides prescription medication coverage. You can get drug coverage along with Part A and Part B coverage through these other plans. But do keep in mind that you must have Part A or Part B to join in one of these Medicare Advantage Plans. And, know too that not all plans offer coverage for prescription medications.

The Medicare website offers a page where you can get Medicare drug plan and Medicare Advantage Plan costs. You can also contact your State Health Insurance Assistance Program (SHIP) office to ask questions regarding your Medicare benefits, premiums, deductibles, coinsurance, and coverage. Representatives can also answer questions regarding joining or leave a Medicare Advantage program.

Joining a Medicare Drug Plan

You can get prescription drug coverage when choosing a Medicare drug plan by enrolling on the Medicare Plan Finder website, completing and mailing in a paper enrollment form, calling the plan office, or contacting Medicare directly at 1-800-633-4227.

Drug Coverage Choices

When considering your prescription medication coverage options, be sure to investigate if you have coverage through any other program. Many employers or unions and the Department of Veterans Affairs (VA), and other agencies offer drug coverage for specific prescriptions. When you elect to have Medicare drug coverage, your drug coverage from these other programs may change. Thus, you must look into all options so that you can receive the best coverage possible.

Further, if you join a Medicare Advantage Plan, you will likely receive prescription medication coverage through that plan. Also, if you are part of a Health Maintenance Organization (HMO) plan or a Preferred Provider Organization (PPO), you will be removed from your Medicare Advantage Plan and placed back on the Original Medicare program.

You can only join an independent Medicare Prescription Drug Plan without risk to your current health coverage if you are part of a medical savings account plan, a cost plan, a private fee-for-service plan, or certain employer-sponsored Medicare health plans.

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