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Medicare Drug Plan
What is Medicare Prescription Drug Coverage
Who Is Eligible?
When Should I Enroll?
What Does It Cover?
What Does It Cost?
- Monthly premium—This is the monthly fee that drug plans charge.
- Yearly deductible—This is the amount of money you must pay for your prescriptions before your plan begins to pay.
- Co-payments—This is the amount you pay at the pharmacy for your covered prescriptions after the deductible has been reached.
- Coverage gap—Most drug plans have a coverage gap. After you and your drug plan have spent a certain amount of money for your covered medications, you have to pay all costs out-of-pocket for your prescriptions up to a yearly limit.
- Catastrophic coverage—After you have spent up to your plan’s out-of-pocket yearly limit for covered drugs, this allows you to only pay a small co-payment for the drug for the rest of the year.
- Late enrollment penalty—This penalty is added to your Part D premium if you have a period of time when you have not been covered by Part D or another prescription drug plan.
Are There Ways to Lower the Costs?
How Should I Make My Decision?
- What drugs are you taking now? Does the Medicare plan you are considering cover most of the costs for those drugs?
- Does the pharmacy you use most often carry the drugs covered by the plan? Here, your pharmacist can help you to choose the right plan.
- How much can you afford to spend on a drug plan?
- Do you have all the information about other insurance coverage you may have?
- Is the plan you are considering flexible enough to change if your health changes?
How Can I Get More Information?
Social Security http://www.ssa.gov
Drug coverage (Part D). Medicare.gov website. Available at: http://www.medicare.gov/part-d/. Accessed October 31, 2013.
Enrolling at the right time. AARP website. Available at: http://www.aarp.org/health/medicare-insurance/info-04-2011/medicare-enrollment.html. Updated May 7, 2012. Accessed October 31, 2013.
Extra help with Medicare prescription drug plan costs. Medicare.gov website. Available at: https://secure.ssa.gov/i1020/start. Accessed October 31, 2013.
Get help paying costs. Medicare website. Available at: http://www.medicare.gov/your-medicare-costs/help-paying-costs/get-help-paying-costs.html. Accessed October 31, 2013.
Medicare Advantage plans. Available at: http://www.medicare.gov/sign-up-change-plans/medicare-health-plans/medicare-advantage-plans/medicare-advantage-plans.html. Accessed October 31, 2013.
Medicare and you: 2014. Medicare website. Available at: http://www.medicare.gov/Publications/Pubs/pdf/10050.pdf. Accessed October 31, 2013.
- Reviewer: Michael Woods, MD
- Review Date: 10/2013
- Update Date: 10/31/2013