Part D is a prescription drug program. Anyone with Part A or Part B is eligible. To receive prescription drug coverage, you must enroll in a separate plan. Medicare does not offer Part D plans. These plans are approved and regulated by Medicare, but are administered by private companies. “Plans choose which drugs (or even classes of drugs) they wish to cover, at what level (or tier) they wish to cover it, and are free to choose not to cover some drugs at all.” There are standards that these companies must comply with, but the coverage can still vary widely.
If you have enrolled in Part C, you should be able to get prescription drug coverage through your HMO or PPO. You cannot purchase a policy through Part D.
Medicare offers the Medicare Plan Finder to help you find the prescription drug plan that is best for you. You will need to enter all of the drugs you take, the dosages, and frequency. Medicare will then generate a list of plans in your area that cover your prescriptions.
When I entered my information, I got a list of 32 plans. Policy premiums and deductibles were included. There was also a rating next to each plan, indicating Medicare’s satisfaction level with the company. This is great because it can narrow down your choices and help avoid a costly, possibly unpleasant experience.
You can enter the policy price range. Then you only have to review those that meet your qualifications.
The costs for premiums vary widely, as does the coverage. The average price per month is about $60. There are some policies listed as high as $300 per month and some as low as $12. The deductibles range from $0 to $310, which is the maximum allowed. Most have a 25 percent co-pay for each prescription.
The low-cost plans are subsidized, and you will need to qualify for them. Medicare has a program called Extra Help that assists low-income individuals with prescription drug costs. Participants save an average of $3,900 per year. You can apply online.
The Medicare Savings Program (MSP) can direct you to the requirements for your individual state for help with your Prescription Drug Plan. If you qualify, it may also pay your Part A and Part B premiums.
As we have seen Medicare is a great benefit that provides health care coverage for those over 65. The program was designed to bring medical care to seniors at an affordable rate. The idea was that all American workers should be entitled to quality health care.
In general, as we age, we have more conditions that need medical care. For many of us, this is also the time where our income is lower and when we need the help. We have paid for this service in advance to insure we receive quality care as we age. Medicare is in place so that those of us who contributed can be comfortable in knowing that we will be taken care of.
Excerpts from Retirement Basics: Help for Broke Baby Boomers