
What Are Medicare Excess Charges?
Medicare excess charges are one of those complicated Medicare topics which tends to raise questions for potential Medicare Supplement plan enrollees. Read on to find out what you
In need of personalized Medicare advice? Get free guidance today.
In need of personalized Medicare advice? Get free guidance today.
In need of personalized Medicare advice? Get free guidance today.
In need of personalized Medicare advice? Get free guidance today.
In need of personalized Medicare advice? Get free guidance today.
Medicare excess charges are one of those complicated Medicare topics which tends to raise questions for potential Medicare Supplement plan enrollees. Read on to find out what you
In need of personalized Medicare advice? Get free guidance today.
In need of personalized Medicare advice? Get free guidance today.
Medicare Part D is an optional part of Medicare that offers prescription drug coverage.
Medicare Part D can be obtained through a number of private insurance companies. Medicare Part D offers prescription drug coverage to go along with your Original Medicare coverage. Additionally, you have the option to sign up for a Medicare Advantage plan that includes prescription drug coverage.
Medicare Part D helps pay for both generic and brand-name drugs. Medicare prescription drug plans all have their own drug list (also called a formulary), and all plans must cover at least two drugs per category.
However, Medicare Part D plans are not required to cover certain drugs, such as weight loss and weight gain medications, medication for erectile dysfunction, and over-the-counter drugs.
But Medicare Part D drug coverage does include almost all drugs in the following protected classes:
Each drug plan’s formulary divides its medications into different drug tiers. Drug tiers are commonly organized as follows (though your plan may have a different way of organizing its drug tiers):
In general, the higher the tier, the higher the copayment/coinsurance you will be responsible for covering.
Medicare Part D drug plans can change their coverage details over time or even throughout the year. That’s why it is so important to stay up to date on policy changes. A licensed insurance agent here at Medicare Plans Direct can answer any questions you may have about Medicare Part D prescription drug coverage.
You will have to pay a monthly premium for your Medicare Part D prescription drug coverage, and your premium amount will depend on the plan that you choose. You will want to do some research into a plan’s formulary before deciding whether or not it is right for you. While a plan may appear to be the more affordable option at first glance, it may not cover the medications that you need.
There are four stages of Medicare Part D prescription drug coverage that affect how much you need to spend out-of-pocket on your medications over the course of the year:
Once the calendar year ends, your Medicare Part D status resets and you return to the initial deductible stage.
Some low-income individuals may qualify to have the cost of their prescriptions subsidized. Extra Help , or the Part D Low-Income Subsidy, helps qualifying individuals to pay for their drug costs. Benefits can extend to cover your Medicare Part D monthly premium, deductibles, coinsurance, copays.
You are automatically eligible for Extra Help if you are receiving full Medicaid coverage from a state program or are receiving Supplemental Security Income (SSI) benefits. If you think you may qualify for Extra Help but aren’t sure, consult with one of our experienced insurance agents today.
Once you turn 65 and are eligible for Original Medicare, you will have the option to enroll in a Medicare Part D drug plan. However, to do so, you must also be enrolled in Medicare Part A and/or Part B.
Additionally, even if you are not yet 65, you may be eligible for Medicare Part D prescription drug coverage if you have a disability, ESRD, or ALS.
If you have a Medicare Advantage plan that already offers prescription drug coverage, you cannot enroll in a separate Medicare Part D plan.
You must enroll in a Medicare Part D plan in the service area where you reside, and there are multiple ways to do so.
You have a couple of options when it comes to enrolling in Medicare Part D prescription drug coverage.
You can either get prescription drug coverage through a “stand-alone” medicare drug plan. Alternatively, you can enroll in a Medicare Advantage plan that includes prescription drug coverage.
You should be aware that some Medicare Advantage plans don’t offer a prescription drug benefit. If your Medicare Advantage plan doesn’t come with drug coverage, you may or may not be able to enroll in a stand-alone drug plan.
Examples of Medicare Advantage plans that don’t allow you to enroll in a stand-alone drug plan if your policy doesn’t come with prescription drug coverage are HMO and PPO plans.
We recommend that you consult with a Medicare insurance expert to ensure that you are getting the Part D plan or Medicare Advantage policy that is right for you.
You can enroll in Medicare Part D when you are first eligible for Medicare. This happens during your IEP, or when you first sign up for Original Medicare. This is the seven-month period that starts three months before your birthday month, includes your birthday month, and lasts until three months after your birthday month.
You may also have the option to enroll in Medicare Part D drug coverage during a Special Enrollment Period (SEP), which you can be granted in certain circumstances.
Finally, you can enroll in a Medicare Part D drug plan during the Fall Open Enrollment period (October 15-December 7 each year). If you are leaving a Medicare Advantage plan to go back to Original Medicare, you can enroll in Part D during the Medicare Advantage Open Enrollment Period (January 1-March 31 each year).
If you’re confused about when you can enroll in Medicare Part D, or aren’t sure which drug plan could be right for you, set up a consultation with one of the team members here at Medicare Plans Direct.
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