What Are Medicare Part D Plans?

What is Medicare Part D? Before you purchase, you will need to understand the prescription drug coverage available to you.

Medicare Part D Plans came into existence in late 2005 early 2006. The initial roll out of this new plan caused nightmares for insurance companies, patients, doctors, nurses and drug companies.

There are two different ways you can sign up for Medicare Part D Plans. You can get a stand-alone plan, which adds drug coverage to the original Medicare Part A and B.

Otherwise, you can enroll in a Medicare Advantage Plan, which covers all of Medicare Part A and B and includes prescription drug coverage as well.

Medicare Part D Enrollment

You are eligible to enroll in a Medicare Part D plan during your initial Medicare eligibility period and you can add, drop or switch plans any time during the yearly open enrollment period.

In 2012, open enrollment begins Monday, October 15 and continues through until Friday, December 7. You can make changes to your coverage anytime between those two dates. Changes will not take affect until 2013.

However, the penalty for late enrollment can be quite significant.

If you don't sign up for one of the Medicare Part D Plans when you are initially eligible, which is a 7 month period extending from 3 months before you turn 65 until 3 months after you turn 65, you will be assessed a penalty when you do decide to sign up, unless you had other prescription drug coverage through an employer or a union.

The penalty is 1% of the national base premium which will be added to your premium for each month you went without coverage from the time period you first became eligible. That additional penalty will be added to your premium for the life of your Medicare approved prescription drug coverage.

It is best to sign up for prescription drug plans as soon as someone becomes eligible. If that didn't occur, there will be an additional penalty for each month longer you wait, so even though you will pay a penalty, waiting will only make that penalty larger every month.

Medicare Part D Formulary

Different Medicare Part D Plans differ in what they cost; how much, if any, is their deductible; what drugs they cover and which pharmacies they utilize. Choosing a Part D Medicare Plan takes some effort to ensure your out of pocket expenses are manageable and provides the coverage you need throughout the year.

Be aware that there is a "coverage gap", also referred to as the Medicare Donut Hole , during which you will be responsible for a much higher share of your prescription drug costs.

I would recommend not only talking to a variety of insurance plans offered in your area, but also your local pharmacists for assistance in making sure the medications you are currently on will be covered by the plan you choose.

Once you are enrolled in a plan, if your physician prescribes additional medications throughout the year, you should have a copy of your formulary and in most cases, the doctor will choose a drug that is covered by your plan.

If the plan you initially chose does not meed your needs, you will have the opportunity once every year during open enrollment when you can change your plan without incurring a penalty.

Medicare Part D Plans can be quite confusing and the government seems to make changes to them every year, so what was true in 2009 may no longer be true in 2013. It may be in your best interest to review your current plan each year. A Medicare specialist in your local area can help you with this.

You can go to Medicare.gov to keep up on all the changes that occur from year to year.

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