Medicare Part D

Medicare Part D provides prescription drug coverage. Insurance companies offer this benefit either as an independent plan or beneficiaries can select a Medicare Advantage plan that also includes prescription drug coverage. 

Medicare Part D Coverage

Every Part D plan has a formulary, which is a list of drugs that are covered. If the drug you require is not on the formulary, you may request an exception, pay out of pocket, or submit an appeal. 

The formularies vary from plan to plan, so you should request a copy. But each plan has to cover all drugs in these categories:

  • Antidepressants
  • HIV/AIDS treatment
  • Immunosuppressants
  • Antipsychotic medications
  • Anticonvulsive treatments for seizure disorders
  • Anticancer drugs (unless they are being covered under Part B)

Also, Part D covers most vaccines unless they are already covered under Part B.

Part D Cost

Monthly premiums and copay for Part D vary from plan to plan.

However, as previously mentioned, every plan has a formulary that records the different drugs that are covered. The cheapest plan is not always the best plan. Talk with a Medicare agent like Ron Ray who will verify that the plan you want will cover 100% of your drugs.

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How to Enroll in Prescription Drug Coverage

For Medicare Part D, you can only enroll in the service area where you live. You can enroll through an insurance carrier that is certified in Medicare services. Or, you can enroll through Medicare’s website.

There are some Medicare Advantage plans that also contain Part D coverage. If this is how you want to get your prescription drug coverage, double check to make sure it covers 100% of the drugs you need. 

Enrollment Periods

You are able to enroll in prescription drug coverage when you enroll in Original Medicare. This is the three months before your 65th birthday and the three months after you turn 65. 

Also, the annual election period is from October 15 through December 7. You can enroll or disenroll from any drug plan during this period. 

The insurance company will send you an Annual Notice of Change every September. This is a letter that explains all changes coming regarding your plan. Then, you can choose whether or not to make a change. 

You do not have to do anything if you want to keep your current coverage. It will automatically start over in January. 

For all of your prescription drug questions, give us a call at 830-217-6711.

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