Why Purchase Medicare Part D
Medicare has four parts. The original Medicare consists of Parts A and B, the original federal program. Part C is Medicare Advantage. Medicare Part D is prescription drug coverage, which helps cover the costs of medicine. Prescription drug coverage is optional. Additionally, it is only available through private insurance companies approved by the federal government. While it is optional, Part D is offered to everyone who qualifies for Medicare. Costs, of course, can vary from plan to plan depending on the provider.
How to Get Medicare Part D?
There are two different ways to acquire Medicare Part D:
Purchase a standalone prescription drug plan. If you have Medicare Parts A and B, you can choose to add Part D to cover the costs of prescription drugs. The cost is separate cost from any existing coverage.
Purchase a MAPD. Medicare Advantage Plans include Parts A and B. And, many include prescription drug coverage.
What Does Medicare Part D Cover?
Each Medicare Part D plan has a list of approved drugs. This list is the formulary. Formularies identify what is covered and what is not covered. Plans sort their list of prescriptions into categories called tiers. Usually, drugs in a lower tier will cost less than drugs in a higher tier. The tiers often go from one to five or six. Tier one is low-cost. These are typically common generic RX. Tier five or six are specialty drugs. These are the highest cost drugs and specialty medications. Not all medications are covered by Medicare Part D, however. Coverage may be limited due to medical necessity, availability, cost, or safety.
How To Enroll in Medicare Part D
Usually, if you qualify for Medicare, you qualify for Medicare Part D. However, beneficiaries must have a qualify for a valid enrollment period.
Your Medicare Initial Enrollment Period (IEP): You can enroll in a Part D plan in the 3 months you turn 65, the month of your 65th birthday or 3 months after.
The Medicare Annual Enrollment Period (AEP): This runs from Oct. 15 to Dec. 7 every year. During the AEP, you may make changes to your Medicare Part C and Part D coverage. They will take effect on Jan. 1 of the following year.
The Medicare Advantage Open Enrollment Period (OEP): This lasts from Jan. 1 to March 31 each year. You may add, drop or change your Part D coverage during this time.
Special Enrollment Period (SEP): You may be able to enroll in a new Part D plan if you’re eligible for an SEP. You may qualify for an SEP under certain circumstances, such as if you make changes to a job-based drug coverage plan, or if you have or lose Extra Help.