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How to Secure Prescription Drug Coverage with Medicare

medicare part d coverage

Table of Contents

Orlando’s Premier Medicare Broker Insights 2024: 40% of Beneficiaries Over 65 and Rising Prescription Coverage Costs

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 coverage to avoid paying costly prescription costs out of pocket. That adds up to over 50.5 million people. Click here to learn more about Medicare Part D coverage.

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! As mentioned earlier, a total of 50.5 million people are currently enrolled in plans that provide the Medicare Part D drug benefit, including plans open to everyone with Medicare (stand-alone PDPs and MA-PDs), and plans for specific populations (retirees of a former employer or union and medicare Advantage Special Needs Plans, or SNPs).

  1. A new law, the Inflation Reduction Act, caps seniors’ prescription drug costs covered under Medicare, starting in 2025, to $2,000, and beginning next year allows no more than a 6% annual jump in Part D premiums.
  2. The cost of the average premiums will rise between 42% and 57% in 2024 compared to 2023 in five states with the largest populations of individuals over 65 who are on Medicare: California, Florida, New York, Pennsylvania, and Texas.
  3. Overall, average monthly premiums for Part D will be “substantially higher” in 2024, according to an analysis by KFF, a nonprofit provider of health policy research.
  4. The national average monthly Part D premium, not as lofty as the HealthView Services calculation, is projected to increase 21% in 2024 to $48, up 21% from $40 in 2023, according to KFF.


How to Qualify for Medicare Prescription Drug Coverage with a Licensed Florida Medicare Broker

You must enroll in Medicare 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 is 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.

Medicare 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 MedicarePart D plan, reach out to us today to compare all your options.


Steps 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 You Opt for 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.

Do you have further questions about Medicare Part D prescription drug coverage? Medigap Supplement Headquarters has experienced Medicare professionals that can answer all of your important questions. Contact us today by filling out the form below.


Dale Wondisford, Medigap Agent

15 Years experience helping hundreds of families get the best insurance policy to meet their needs.