Medicare Part D Prescription Drug Plans

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Medicare Part D Prescription Drug plans help cover the out of pocket expenses Medicare doesn’t cover. Some policies have a higher premium and more comprehensive coverage. Although, some policies boast a lower premium in exchange for less coverage.

Those with Medigap and Medicare should choose a stand-alone Part D plan. Enrollment outside of the Initial Enrollment Period is between Oct. 15th through Dec. 7th, this is known as the Annual Enrollment Period (AEP).

Beneficiaries that delay enrollment will incur a penalty of 1% each month you could’ve had coverage. It’s important for beneficiaries to understand their Part D eligibility and enrollment periods.

Part D Medicare Prescription Drug Plans

Medicare Part D Prescription Drug Plans

Medicare Part D Prescription Drug Plans make getting prescriptions easier

Most Part D plans are either basic or enhanced coverage. Since everyone has a different medication schedule, the best policy depends on the list of necessary prescriptions. Someone with many brand name drugs would spend too much out of pocket on a basic policy; however, a basic policy could benefit many people across the nation.

There are many PDP plans available in the United States. The lowest costing policy isn’t always the best policy. Sometimes beneficiaries save more money annually by paying a higher monthly amount.

The Lowest Premium PDP isn’t Always the Best PDP

Let’s say Marsha has basic Part D coverage, it only costs her $14 a month. Marsha believes this policy is the best one because the premium is the lowest one in her area. Well, she never really took a good look at the coverage.

See, this policy has a $415 deductible that must be met before coverage begins. Additionally, Marsha takes brand name medications that this policy won’t cover since the coverage has limitations. After the deductible, Marsha pays $200 a month for her prescriptions on this policy.

Well, Marsha could have chosen coverage with more benefits and a higher premium. Marsha enrolls in the $50 policy that has no deductible; now her drugs only cost $50 out of pocket and she’s saving over $100 a month by paying a higher premium.

If you’re unsure about the Part D plan that best suits you, contact a Medicare broker to discover your best coverage.

Annual Changes

The costs and features of a prescription drug plan aren’t set in stone. They have the potential to change on a yearly basis. Insurers may adjust their rates and decide to drop or start covering specific medications.

Thankfully, in 2020 the donut hole is closing. This means beneficiaries won’t pay quite as much out of pocket on prescriptions.

However, these companies must tell you about upcoming policy updates. A document called the “Annual Notice of Change” reveals any new policies that will take effect in January. This gives you an opportunity to switch plans.

All Part D Plans Have Restrictions

Most drug plans have restrictions on pain medications, opiates, and narcotics. Those taking pain medication should regularly be ready to deal with extra paperwork. Almost all Part D policies require some kinds of quantity limits, step therapy, or prior authorization on these kinds of medications.

No matter which company you choose to enroll in, these restrictions are normal on these types of drugs. Choosing a policy with the lowest annual estimated spending can make it worth changing policies. After submitting an application the best way to get as much approval as possible is to file any exception forms immediately.

Some medications, such as a compound medication, won’t have coverage by Medicare Part D Prescription plans. This is an instance when you must file an exception. All exceptions aren’t going to receive approval, so prepare to pay for medications out of pocket.

The Easiest Way to Get Coverage

Prescription drug plans can be difficult to navigate. Many beneficiaries unintentionally select a policy that doesn’t cover the medication they need, or they choose a policy that has drug restrictions they weren’t ready to handle.

Also, it’s common for new Medicare beneficiaries to fail to enroll in a policy when first eligible. Well, here at MedicareFAQ we’re here to ensure the help is here for you when you need it. Our brokers walk you through everything at the beginning of your policy.

Then, once you have an active policy, our client care team offers their time and insurance knowledge to you at the sight of any Medicare hiccup. We want you to feel confident in your coverage at all times. Give us a call at the number above to get started! Or fill out an online rate form to compare rates online!