Medicare Part D is a prescription drug plan that provides coverage to all people eligible for Medicare. In addition to using different pharmacy networks, all Medicare-sponsored prescription plans have different formularies, premiums, deductibles and co-pays. Enrollment is voluntary, however the website Medicare.gov notes people who do not enroll when first eligible may incur a penalty should they decide to purchase coverage at a later date. Only FDA-approved prescription drugs sold and used in the United States qualify for coverage. People with existing prescription coverage through Medicare or an employer, union or government retirement health plan, should consult with a benefits advisor before enrolling in a Part D drug plan.
Step 1
Contact Medicare or visit the Medicare website and determine which plans are offered in your area (see Resources).
Step 2
Compile a list of current prescription medications and verify which plans' formularies provide coverage for those medications. Nonprescription drugs, certain barbiturates, anti-anxiety drugs and drugs prescribed for cosmetic enhancement, weight issues, fertility or sexual dysfunction are not covered by any Medicare-sponsored drug plans.
Step 3
Compare the premiums and deductibles for each plan. Plan premiums vary, and annual deductible amounts can range from zero deductible to $250 or more per annum depending upon the type of plan selected, according to Drugs.com. Confirm the amount of co-payment and establish whether the cost is based on the amount of purchases, a percent of the overall cost or a specific amount for each drug.
Step 4
Verify the amount of coverage gap for each plan under consideration. Most Medicare drug insurance plans require the consumer to pay 100 percent of the drug costs after a certain limit is reached and before the catastrophic coverage kicks in.
Step 5
Ask the local pharmacy which Medicare prescription drug plans it accepts. Most major retailers and network pharmacies accept most major plans, but it is important to confirm to avoid unexpected out-of-pocket expenses.
Member Comments