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What Do Medicare Drug Plans (Part D) Cover and How to Save the Most Money With This Plan

As individuals grow older, health care becomes an increasing priority with increasing age. Once an individual reaches the age of 65, they’re automatically eligible for Medicare through the government. Some may find that Medicare is not all inclusive when it comes to health insurance.

One of the most vital and common uses of health insurance is it helps pay the cost of prescription medication. The basic provision of Medicare although is Part A which is only hospitalization and doctor’s visits. Prescription drug coverage, on the other hand, is under Part D and it is considered as an “optional” category under Medicare. Despite the fact that it may not be a standard coverage benefit, it is still vital and there are ways to save money while using Medicare Part D coverage.

What Medicare Part D Covers

Medicare Part D typically covers a wide variety of prescription medication but each drug plan has a list of covered drugs. It is also an additional cost to standard Medicare health plans, the cost will vary based on the medication an individual takes. Typically, Medicare drug plans do have a monthly cost, a deductible, co-payments/coinsurance, and other costs just like a regular health insurance plan.

Saving Money With Medicare Part D Plans

There are a variety of ways to save money with Medicare prescription drug plans, especially with the help of private insurance companies or insurance providers within the health insurance marketplace. Before exploring your options to save money with Medicare Part D, be sure to evaluate your current prescription medications that you take or will need to take in the near future. In addition, also check the retail value of your medication to avoid getting a plan where your medication will fall into the “donut hole” as listed above.

Ways To Save On Medicare Part D:

  • Purchase Humana Health Insurance using their Medicare Advantage Plans
  • Shop and enroll in a subsided health insurance plan through the insurance marketplace
  • Enroll in a Medicare Savings program.
  • State Offered Insurance Programs
  • Apply for Dual Enrollment with Medicaid

These programs will look into certain factors when determining your eligibility for these assistance programs under Medicare Part D. These can include your income from employment (if applicable), income from disability, income from social security, or sources such as the amount in your checking/savings, retirement funds, stocks, and bonds.

The Medicare Part D Coverage Gap

Medicare Part D also is known for the coverage gap (aka the Medicare donut hole), which is a period of payment for prescription drug expenses that have a cost between the initial coverage limit and the catastrophic coverage threshold. This is where drugs that are “listed” as coverage by Medicare Part D may not be covered due to pricing, this can also occur if a prescription drug manufacturer feels the need to increase the retail price of medication.

Saving Money On Prescription Drugs with Medicaid While Receiving Medicare

Medicaid is your state’s health care provider for low-income individuals with limited resources. Since Medicaid is operated by the state you reside in, the statues for dual-enrollment with Medicare may vary. It does not make a difference whether you apply before or after receiving Medicare. As long as you meet your state’s qualifications for Medicaid. An exception to consider however is if you’re on disability and are in the 24 month waiting period before becoming eligible for Medicare, you may be eligible for Medicaid during that time period. Contingent on your state’s Medicaid policies, you may also be able to continue to receive Medicaid after Medicare coverage starts hence the dual enrollment benefit. With this provision you are able to receive coverage for prescription drugs under Medicaid, although it may not be the same as Medicare Part D, it will still cover a broad range of medications that you currently are prescribed to or will need to take in the future.

Applying for Medicare Part D

When applying for Medicare Part D, the person needs to apply 60 days before turning 65, this way there’s a decent chance of getting the plan to start by January of the new year. Providing that best time to apply is from October 15th to December 7th. Applying for Medicare can be completed in three ways, online, by telephone, or in person at the local social security office. Medicare and Social Security offer a program that will provide people with limited income to assist in paying for prescription medications. If they are eligible for the program they could pay only $3.35 for generic medications and $8.35 for brand-name medications.

How To Apply For Medicare Part D

At a minimum, all Medicare Advantage plans must offer the same Medicare Part A and Part B benefits as Original Medicare. To get Medicare Part D You must have Original Medicare, in order to enroll in a Medicare Advantage plan through a private insurance provider.

  • Determine your medical needs whether you will need Medicare Part A only or Medicare Part B in addition to Part A.
  • Fill out an application in One Of Three Ways: Online at www.socialsecurity.gov (there is an option where someone can help you fill out the application online if needed), Calling Social Security at 1-800-772-1213, OR Visit Your Local Social Security Office
  • Wait For Approval Of Medicare Part A
  • Once enrolled in Medicare Part A, Complete an Application for Enrollment in Part B (CMS-40B) if you choose to have Part B. Skip this step if you do not want Part B. NOTE: Sometimes you may automatically be enrolled, if so and you do not want Part B, follow the instructions back or call Social Security.
  • Follow The Online Steps To Enroll In Medicare Part D.

Medicare Prescription Plan

When an individual reaches the age of 65, they’re automatically enrolled in the Medicare program. Hospitalizations are covered under Part A, but what about the cost of medication after returning home from the hospital? These costs can add up and cause financial strain on loved ones caring for the individual. Medicare Part D can assist with a low monthly cost; however, the cost can vary depending on what type of medication the person may need.

Related imageWeigh Your Options

It’s important for Medicare holders to weigh all their options when choosing a private insurance company or provider to assist with the remainder of the costs of prescriptions. First, they need to search for a provider within their network. Second, they will need to review all of their medications from now and what they may be taking in the future. The quickest way to shop for a subsided health insurance plan is to find a state offered plan or enroll in the Medicare savings program with dual enrollment. They will ask for income based on employment, disability income, social security, retirement, stocks, bonds, and checking and savings accounts.

Humana

Medicare offers an Advantage Plan where the individual signs up with Humana insurance. Humana offers low monthly payments for prescription medications. Co-pays can nothing to a few dollars a month. There’s a deductible of approximately $405 depending on which plan is chosen. Medicare Drug plans can be difficult to understand, although, there is help for individuals and their families to contact for support. The best time to call Medicare is late at night doesn’t matter what state the individual is in, this is the time when someone will answer the phone without a long hold.

The National Patient Advocate Foundation (NPAF)

Is the voice for patients with a chronic, life-threatening illness. They have a dedicated team of medical professionals and volunteers on hand to provide quality care for terminally ill children and adults throughout the United States. The patients see improvement in their daily activities and are able to increase their spirit and understand that they can have a promising future.

The National Organization for Rare Disorders(NORD)

Is a nationwide database that provides individuals and their families with the knowledge to understand what type of disease they have and how to cope with it. With a database of over 1,200 diseases, the NORD gathers their information and compiles it into one source for patients, caregivers, and families to access the information with a click of the mouse.

The National Council of Aging(NCA)

Also known as Benefits Checkup, strives to provide quality improvement and financial security to over 10 million senior citizens by the year 2020. They are also a secure site that will not share any personal information. All it takes is to answer a few simple questions and the patient can have access to the benefits they need.

Medicare for the Disabled and Those Over 65

Disabled and working individuals under the age of 65 can also receive Medicare; however, they need to apply through Social Security Disability, Social Security Income has a two-year waiting period in certain states. Individuals who apply with Social Security Income will receive benefits through Medicaid immediately. Without having SSD, the individual will not receive Medicare until that person reaches the age of 65. Social Security Disability is for someone who has a serious medical issue that may require them to be in a wheelchair or maybe dependant on certain drugs that need to be with them at all times, such as oxygen or an insulin pump. Many SSD people have had medical issues most of their lives, while some may have developed them over time. Accidents and unforeseen circumstances can happen to anyone. It’s important to understand that Medicare and Social Security is there for individuals who need it the most. Social Security can also be reached by phone and they have an extensive website that will enable each person the direct them in the place they need to go. Their questions will be answered in a timely fashion, but they’re not open 24 hours a day.

Keep in mind

The Medicare Drug Plans (part D) can be summarized by saying that they are there to help the individual with any questions they have. Their families and caregivers will be able to assist as well. There’s always a phone number to call at the top of the website and there is also a live chat feature on most of the insurance websites for any questions or concerns. It’s important for the person applying to make sure they write down all the medications they are taking prescribed by a doctor. Sometimes doctor’s change medications often because one might interact with another or the person who could be allergic, whatever the reason, the individual must ensure that the medication list is accurate or they won’t receive coverage for that particular medication.