Medicare Part D

medicare-senior-46

Medicare Part D plans (prescriptions plans) are offered through private insurance with approximately 1045 plans approved by Medicare across the U.S., though only 4-6 plans may be offered and approved in any particular geographic region.

Relocating to a different State will most likely require your plan to change to one of the new specific geographical region’s plans.  However, you will be granted a special Enrollment Period (SEP) allowing you change to a Medicare Plan D in your new region.

2013 Premiums, Deductible & Donut Hole

Premiums for Medicare Part D are as low as $15/month, but the standard deductible is $325.

  • Deductibles have to be met prior to any coverage
  • Once you reach your deductible (which varies based on your plan), you will be charged either a co-pay or a percentage of the cost (co-insurance) based upon the type of prescription (Name Brand vs. Generic) and the cost of the prescription.
  • Once you and your plan have reach $2,970 of prescription coverage during a year, you  reach a Coverage Gap (Donut Hole), where you must pay the cost of the prescription until you reach the out-of-pocket maximum for your specific plan.
  • While in the Coverage Gap (Donut Hole), you still receive the 52.5% discount on Name Brand prescriptions.
  • Full cost of prescriptions will be applied toward the out-of-pocket maximum $4,750 to enable you to transition out of the Donut Hole more quickly.

Important Dates

  • October 15 – December 7 is the enrollment period for coverage starting January 1, 2014
  • If you will turn 65 in 2014, there will be a 7-month enrollment period.
  • The enrollment period begins three (3) months before your birthday month and continues until three (3) months after your birthday month.  Enrollment will be the first day of the month following when you enroll.

**Be aware that if you currently have coverage through your work or union that enrollment in Medicare Part D can disrupt your current insurance through your employer, union or COBRA.

Need Help Paying For Prescription Coverage?

Additional help is availble through Medicare programs designed to help people with limited income and resources.  Call 1-800-MEDICARE (1-800-633-4227) to see if you qualify.

MedicareBenefits.us is not associated with the federal government. All plan information provided on this site is collected from public sources (e.g., cms.gov, carrier's website, plan brochures, etc.). Rates shown are for comparison purpose only. Contact your Medicare agent or Medicare.gov for a binding quote.