How To Get Prescription Drug Coverage Through Medicare?

40% of Medicare beneficiaries over 65 take about five or more prescriptions a day. Prescription Coverage Is The Biggest Out Of Pocket Cost For Most Seniors.

This is a big number, but it emphasizes the necessity of a prescription drug coverage insurance policy. 74% of Medicare beneficiaries have signed up for Medicare Part D to avoid paying costly prescription costs out of pocket. Click here to learn more about Medicare Part D.

Every Medicare beneficiary can get this optional health coverage to help reduce the cost of prescription drugs. If you’re interested in getting this type of coverage, here is how you can do so through Medicare!

How to Qualify For Medicare Prescription Drug Coverage

You must enroll in Part A, Part B, or both plans before signing up for Medicare Part D.
Then you are qualified to get the prescription drug coverage through a standalone Medicare Part D plan. Original Medicare does not provide prescription drug coverage. However, Part B can cover a limited amount of outpatient prescription drugs. In this case, Part D won’t cover what Part B already covered.

It’s also possible to get prescription drug coverage through some Medicare Advantage plans, such as Special Needs Plans (SNPs). Medicare requires a Special Needs Plan to provide prescription drug coverage. However, other Medicare Advantage plans can vary when it comes to providing this coverage.

All Medicare prescription drug plans cover generic and brand-name drugs with formularies. Each Medicare Part D plan has a formulary or the list of medications the plan covers broken down into classes. Prescription drug coverage varies from one plan to another, but each plan must cover at least two drugs from each class.

Part D plans must also cover the drugs that fall under these specific categories:

● Antidepressants
● Anticancer
● Immunosuppressants
● HIV/AIDS medications
● Antipsychotics
● Anticonvulsants

To learn more about which prescriptions are covered by a specific Part D plan, reach out to us today to compare all your options.

How to Enroll in Medicare Part D Plan

As discussed earlier, you need to sign up for Part A, Part B, or both plans first.  Then you can find prescription drug plans in your area.
As a new Medicare beneficiary, you have a 7-month Initial Enrollment Period that starts three months before your 65th birthday month. If you don’t already have creditable prescription drug coverage, you should also enroll in Part A and B at this time. However, enrolling past this Initial Enrollment Period can result in fees and is not always recommended!

Now, suppose you do choose to enroll in Part D later. In that case, you can do so during the Annual Enrollment Period (October 15 to December 7). But, keep in mind that you could face a late enrollment penalty.

Should I get a Medicare Part D Plan?

Even if you don’t currently take that many prescriptions, you should still consider signing up for a Part D prescription drug plan. This plan is optional, and having this coverage already in place for those “what ifs” in life can provide a real sense of security and protection.

Have further questions about Medicare Part D prescription drug coverage? Medigap Supplement Headquarters has experienced Medicare professionals that can get all your questions answered. Contact us today!