Medicare Part D

If you are on Original Medicare and want a prescription drug plan you must sign up for Part D.  Original Medicare Part A and Part B do not include Part D coverage.  Part C can include a prescription drug plan, but you must make sure and ask the companies if its included.  A Medigap plan also does not include prescription drug coverage.  Anyone on Medicare Part A and B can get a prescription drug plan (PartD) even if they are in poor health.  To get a Part D plan you just sign up with a company. 

The first step to getting a Part D plan is to enroll in Medicare.  Ask the social security or Medicare office how and when to enroll in Part D.  Part D coverage is given by private companies such as Blue Cross and Aetna. If you have Original Medicare Part A and B, you can start looking at companies that have a Medicare Part D plan to get yourself coverage. Ask the Medigap companies if they carry a part D plan.  Companies such as AARP have Medigap plans, advantage plans, and they have a Medicare Part D plan.  Other companies such as Mutual of Omaha might have just a Medigap Plan F but no Part D plan.  It is your job as a consumer to ask questions and gather information.  Medigap list can certainly help you with any Medicare Part D questions you may have.  Several Medicare Advantage Plan companies cover prescriptions if you have both Parts A and B.  You can ask the best Medicare Part D rates at Medigaplist. 

There are many people who already get prescription drug coverage through the Veterans Association (VA).  If you are getting drugs through the V.A. and do not want a prescription drug plan, you must make Medicare aware of this.  Call 1-800 Medicare and ask them questions.  If you already have drug coverage through your own private insurer, you don't need to get a Part D plan.  Once again call Medicare and tell them you have a drug plan.  Medicaid recipients can also get drug coverage but must talk to their social worker to gain information.  There are penalties for not getting a Part D plan when you have Medicare Part B but if you have coverage privately or do not want coverage, you don't have to take it.  Ask a Medigaplist agent if he/she can help you with Medicare part D information.  There is a premium that Medicare Part D recipients must pay for coverage, but there are state and government subsidies available.  In states such as Pennsylvania, there is "PACE" that can help for low income families.  Ask us what the phone number is and we would be glad to help.  

Many people ask about the "donut hole" in Medicare Part D.  This is the infamous name for the coverage gap in Part D.  The Donut hole amount changes but the concept basically stays the same.  Once you reach a certain "retail cost" for your drugs per calendar year, you fall into the "Donut Hole".  In 2012, once the Part D plan and yourself reach an out of pocket expense of $2,930 on covered drugs, you're in the "Donut Hole".   Once you enter the "Donut Hole", you will be responsible for 50% manufacturer-paid costs on covered brand-name drugs (This is for 2012, in the future this could change).  

When you spend retail costs over $4,700 out-of-pocket for the year, you're out of the "Donut Hole". Once you get out of the donut hole for Medicare Part D, you fall into what is called "catastrophic coverage." This is when you pay a smaller portion of the drug costs for the remainder of the year.   


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