Medicare Part D

Medicare Part D prescription drug plan is a federal program administered through private insurers approved by Medicare. Medicare Part D was designed to help make prescription drugs more affordable for enrollees. This part of Medicare offers a broad range of prescription medication coverage.

You can decide to sign up in either a standalone prescription drug plan to supplement your Original Medicare or purchase a Medicare Advantage Prescription Drug plan that covers all Original Medicare benefits, including prescription drugs.

How a Medicare Part D Plan Works

Medicare Part D will be made available in your state of resident every year. Part D premiums vary extensively depending on the insurer and plan type, among other factors. If you need specifics like the premium costs and plan features, you’ll need to look for an overview of the drug plan coverage as it applies to your resident state. You can also contact Great Nation Insurance for more details.

While costs vary with Medicare Part D plans, Medicare sets a limit on how much carriers can charge you for annual deductibles. Many plans don’t have annual deductible policies, and the coverage starts as soon as you buy your first prescription.

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What Does Medicare Part D Cover?

Medication coverage depends on the Medicare Part D plan you purchase. All Medicare Part D plans have a formulary, which is a list of drugs covered in a plan. Each plan is required to cover at least two drugs from every category. If your physician prescribes a drug that is not on your list and doesn’t have an alternative, you can request an exception. All Medicare Part D plans must cover these classes of drugs:

  • Cancer treatment medications
  • HIV medications
  • Immunosuppressants
  • Antidepressants
  • Anticonvulsants
  • Antipsychotics

In addition, each plan is separated into tiers. The lower tiers that usually contain generic drugs have a lower copay. If your physician doesn’t think any of the medications in the lower tiers will be effective in treating your condition, you can also request an exception. An exception may help beneficiaries pay less for the medication in a higher tier.

Medicare Part D Eligibility

Generally, you can sign up for Medicare Part D when you enroll in Original Medicare. This includes when you turn 65, receive Social Security disability benefits for at least two years, have end-stage renal disease (ESRD), or amyotrophic lateral sclerosis (ALS).

Medicare Part D Enrollment Period

You can enroll in the Part D plan during the Initial Enrollment Period, which begins three months before your 65th birthday. Open Enrollment Period, which starts on the 15th of October and runs through the 7th of December, allows you to switch out of your current Part D plan or join a new Medicare Part D plan during this period.

Let Great Nation Insurance Help You

At Great Nation Insurance, we understand that the many options for Medicare Part D can be confusing. We’ve helped hundreds of Medicare enrollees select the best plan for their needs. Contact us today.