Part D
Medicare Part D also called Prescription Drug Plans are also offered by private insurance companies, and you can comparison shop and choose a plan that best suits your needs.
Part D
Medicare Part D is voluntary, meaning you can choose to have a Prescription Drug Plan. But be careful, if you do not enroll into a Prescription Drug Plan or a plan that includes Prescription Drug coverage, you will be penalized by Medicare. Prescription Drug Plans are often coupled with a Medicare Supplement plan to give more of a complete cover for their members. Remember that Medicare Advantage plans include prescription drug coverage. If you do enroll in Part D when you are first eligible, you will be able to access retail prescription drugs at a more affordable rate and enjoy protection against high costs in the event you need a very expensive medication.
Cost
Monthly premiums for Prescription Drug Plans vary by plan. Premiums are determined in large part by the formulary which is the list of prescription drugs that specific drug plan covers.
Medicare does impose an adjusted premium for those with higher incomes. For 2024 f you earn more than $103,000 annually (for individuals) or $206,000 (married filing jointly) then you will owe the Income Monthly Adjusted Amount (IRMAA). You can call Medicare to see if you may be affected by this rule. Some Prescription Drug Plans have an annual deductible that must be met before your plan begins helping you pay for your medications. Medicare sets a threshold for deductibles each year, and insurance companies cannot charge more than that limit (although they can charge less). For 2024, the maximum deductible allowed for Part D coverage is $545.
How Does It Work?
When you purchase prescriptions at the pharmacy, your Prescription Drug Plan allows for affordable co-pay for your medication. Medications in a Prescription Drug Plan are grouped into tiers that have specific pricing. From your generic drugs to your specialty drugs, your Prescription Drug Plan can offer you coverage. Each time you must purchase a prescription drug in the corresponding tier, you pay the tier co-pay.
Enrollment
You are eligible for Prescription Drug Plans when you first become eligible for Medicare (at age 65). You can consult with one of our Licensed Medicare Agents, who will be happy to explain your plan options, or you can enroll in a Prescription Drug Plan directly through Medicare. Call 1-800-MEDICARE or visit Medicare’s website for enrollment information. If you don’t enroll in Medicare Part D when you are first eligible for Medicare, you can elect a plan later. Each year, during Medicare’s Annual Election Period from October 15 to December 7, you can add, drop, or change your plan selections.
Medicare FAQ's
You are eligible to apply for Medicare during your initial enrollment period which is a 7 month window. 3 months before turning 65, the month you turn 65 and 3 months after turning 65.
The easiest way to sign up for Medicare is online through SSA.gov or by Calling Social Security at 1-800-772-1213. You can also visit your local Social Security Office.
If you are already receiving Social Security Benefits you will be automatically enrolled into Original Medicare, otherwise you will be eligible to enroll during your initial enrollment period that starts 3 months before your 65th birthday.
If you miss your Initial Enrollment Period you can sign up during the General Enrollment period that occurs every year January 1st through March 31st. Coverage becomes effective the month following your enrollment date.
Yes, there are penalties for not signing up for Part B of Medicare and will be added to your premium.
If you need a new Medicare card you can order a replacement card by phone at 1-800-772-1213, or online at the Social Security Administration web site. Make sure you have your Medicare number ready when you call.
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Medicare has neither endorsed nor reviewed this information. Not connected or affiliated with any United States Government or State agency.
We do not offer every plan available in your area. Currently we represent 14 organizations which offer 91 products in your area. Please contact Medicare.gov ,1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.