Medicare Part D
Part D Is Optional But Very Important
Medicare Part D is an optional coverage that helps cover the cost of prescription drugs. Any easy way to remember it is the “D” stands for drugs. Part D may reduce your costs and keep you from paying higher prices when you pick up your meds from a retail pharmacy.
If you’re not taking prescription medication now, you could be prescribed medication in the future. To prepare for the rising costs, you can enroll in Medicare Part D during your Initial Enrollment Period — the months surrounding your 65th birthday.
Every Part D plan has a formulary listing the drugs it covers. You’ll want to make sure your prescriptions are included in the formulary before joining your plan of interest.
How to Get Part D
There are two ways to get Part D: you can enroll in a Medicare Advantage (Part C) plan that has built-in drug coverage, or you can join a separate Part D plan. As long as you have either Medicare Part A or Part B, you’re eligible for Part D.
The costs and coverage often vary by plan and change from year to year. That’s why it’s critical to review your prescription drug plan every year, and Oak Haven Insurance Agency can assist you with this. We help our clients figure out which plan is the BEST choice for them for the coming year.
When to Enroll in Part D
If you have Medicare and you need to add Part D coverage, you can enroll during specific times of the year. It can get confusing, but here’s what you should know:
- If Medicare will be your primary coverage, you should enroll in Part D during your Initial Enrollment Period — when you first become eligible for Medicare.
- During the Annual Election Period, you can join, drop, or change your drug plan. You can also enroll in a Medicare Advantage plan with built-in drug coverage during this time — which is October 15 to December 7 every year.
Get the right coverage at the right price.
Part D Late Enrollment Penalty
If you enroll in Part D after your Initial Enrollment Period and there’s 63 or more consecutive days when you don’t have coverage or other creditable drug coverage — you may face a late enrollment penalty that does NOT go away.
The Exception
If you’re still working at 65 — for a “large” employer (over 20 employees) — and enrolled in the group health plan, you can delay Part D enrollment until you retire. You won’t face a penalty for doing so. However, make sure your employer coverage offers a qualifying drug plan.
When you retire and no longer have that employer coverage, you’ll be granted a Special Enrollment Period to sign up for Part D. Other reasons may also qualify you for a Special Enrollment Period.
Medicare Part D Costs
Costs will vary by drug plan. However, most beneficiaries who are enrolled in Part D should expect to pay some out of pocket costs, which may include the following:
- A monthly premium.
- An annual deductible of $445 in 2021.
- A share of costs of your covered drugs — either a coinsurance or copayment during your Initial Coverage Period.
- A percent of your costs after the Initial Coverage Period and before the Catastrophic Coverage starts.
What Else You Should Know
You can only be enrolled in one prescription drug plan at a time.
If you have Original Medicare and a Medicare Supplement plan, you’ll want to look for a stand-alone Part D plan because Medigap policies don’t cover prescription drugs.
Lastly, Medicare recipients with low incomes and limited resources can get help with Part D costs from the federal government. Find out if you qualify for Extra Help by contacting your local Social Security office or reach out to a Medicare professional.
Get Help from Oak Haven Insurance Agency
Shopping for a Medicare drug plan can be overwhelming because there are so many plan options in most states. The good news? Help is available, and we don’t charge you anything extra for our services. Oak Haven Insurance can help you compare plans and get the right coverage based on the medications you’re taking. Contact us today!
