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Medicare Part D Prescription Drug Plans explained

• Nov 18, 2017 at 4:00 PM

If you are a Medicare beneficiary, or will be soon, you might be concerned about getting prescription drug coverage under Medicare Part D.

Anyone who has Medicare coverage — Part A (hospital insurance) and/or Part B (medical insurance) — is eligible to receive Medicare Part D prescription drug coverage. It’s optional, but in some cases you could face a late-enrollment penalty if you don’t sign up for this coverage as soon as you’re eligible, and then decide to sign up later on.

As a quick overview of how Medicare Part D works, remember, it provides prescription drug coverage through private insurance companies contracted with Medicare. You can get Medicare prescription drug coverage from either of two types of Medicare plans offered by private insurers:

• A stand-alone Medicare Part D Prescription Drug Plan. This type of plan offers only prescription drug coverage, and works alongside your Medicare Part A and/or Part B coverage.

• A Medicare Advantage Prescription Drug Plan that covers both medical services and prescription drugs. This type is for people who choose to receive all their Medicare benefits in one plan. There are several types of Medicare Advantage plans, such as Health Maintenance Organization (HMO) plans and Preferred Provider Organization (PPO) plans.

When you enroll in either type of plan, you might pay a monthly premium to the insurance company as well as the plan’s copayments, coinsurance, and, if applicable, annual deductible. Some Medicare Advantage plans have premiums as low as $0. With any Medicare Advantage plan or Medicare Prescription Drug Plan, you need to continue paying your Part B premium as well.

If you delay enrollment in a Medicare Prescription Drug Plan, and you don’t have other insurance that provides “creditable” prescription drug coverage, you may have to pay a Part D late-enrollment penalty if you sign up for this coverage later.

Creditable coverage means prescription drug coverage that is (on average) at least as good as Medicare Part D coverage.

The late-enrollment penalty is at least 1 percent of the national average premium. It may be added to your premium for each month that you go without creditable drug coverage for more than 63 days. In most cases, you will pay the penalty for as long as you have Medicare Part D prescription drug coverage.

If you are 60 or older, and have a Medicare Part D plan, let Senior Enrichment Services help you review your plan. Open enrollment for Part D is Oct. 15 through Dec. 7.

If you need help finding a Part D plan or would like to switch plans, call Chris at 419-668-6245, ext. 29 to schedule an appointment.

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