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Part D (Prescription Drugs)

The Basics

Medicare Part D, Prescription Drug Coverage, is usually separate from all other coverage. The exception is a Medicare Advantage Plan (Part C) that includes Prescription Drugs, also referred to as an MAPD.

When enrolling in Medicare, with or without a supplement, a Part D must be obtained from a private insurance carrier. Although regulations require certain minimum coverage and maximum out of pocket limits, the premiums, copays, coinsurance and pharmacy network can vary greatly.

Although it is important to review your medications with your agent and compare how each plan meets your needs, remember that your prescriptions can change mid year and drug prices fluctuate. This is why you are allowed to change drug plans each year during open enrollment, or if you move to another state or plan area.

PART D PENALTY

A common error is to not enroll in Part D because you take few or no prescriptions at the time you enroll in Medicare.

If you do not have prescription drug coverage and then you decide to enroll later in life, you are assessed a penalty for each month that you did not have drug coverage. The number of months is calculated against the present average drug plan and the penalty is added to your premium every month in perpetuity!

Depending on how long you went without coverage, this might be a few dollars a month, or it could be $50 a month or more.

Your agent can assist you in calculating your probably penalty if applicable.

This graphic of pills arranged in the shape of the letter “D” may help you understand Medicare Part D better. If not, make an appointment and I will be happy to go over prescription drug coverage options with you.