Prescription Drug Coverage Explained

Medicare Part D is a prescription drug program offered by private insurance carriers. As many people do, you should ensure you enroll in a Medicare Part D program if you take prescription medications. These plans are designed to reduce the cost of prescription drugs. If you are eligible for Medicare Part A and B, enroll in Medicare Part D at the same time, or you will risk paying a lifetime penalty if you choose to enroll in a program later.

Every company that offers Medicare Part D issues a “formulary” or a list of the prescription drugs the plan covers. The formulary will vary based on the plan type and the insurance carrier. To enroll in the right plan, we will review the formulary together to determine which of the medications you take are covered.

To put Medicare Part D in place, we can help you choose a plan that suits your budget, as you will pay a monthly premium. The premiums vary from plan to plan. You will also share the cost of the medications until you reach the limit for the plan’s out-of-pocket costs. In most plans, after you reach the policy limit, you must pay only 25 percent of the cost of medications until you reach the next level. Once you have passed the out-of-pocket costs at that level, your copay or coinsurance costs will reduce even further. You can also opt to have your Part D premiums deducted from your Social Security benefits every month.