Part D

What is Medicare Part D? Elderly-Couple-On-Park-Bench-Under-Medicare-Part-D-Sign

What Does Medicare Part D Cover For Seniors?

This is a federal program that provides prescription drug coverage to people who are eligible for Medicare. It was established in 2003 as part of the Medicare Modernization Act and went into effect in 2006. It is available to people who are enrolled in Medicare Part A and/or Part B, and it is designed to help people pay for the cost of prescription drugs.

Medicare Part D is offered through private insurance companies that are approved by Medicare. These insurance companies offer different plans that vary in terms of their premiums, deductibles, and cost-sharing requirements. People who are eligible for Medicare can choose a plan that best meets their needs.

Who Is Eligible And When Can They Enroll?

To be eligible, you must be enrolled in Medicare Part A and/or Part B. You must also live in a service area where a plan of this type is available. Anyone living in Greenacres, Boca Raton, and Port St. Lucie can easily find plans in their area. Those who have limited income and resources may be eligible for extra help to pay for the cost of their prescription drugs.

The initial enrollment period, when you first become eligible for Medicare is 3 months before your 65th birthday. You can also enroll or change plans during the annual enrollment period, which runs from October 15 to December 7 each year. In certain situations, such as if you move out of your plan’s service area, you may be eligible for a special enrollment period.

It’s important to enroll when you first become eligible at age 65, as there may be penalties for late enrollment. The penalty is calculated based on how long you went without coverage and can be added to your monthly premium for as long as you have coverage.

What Out-Of-Pocket Expenses Can You Expect?

Medicare Part D plans have different cost-sharing structures, but most plans have the following basic costs:

  • Monthly premium: This is the amount you pay each month to be enrolled in the plan.
  • Deductible: This is the amount you pay out of pocket before your plan starts covering the cost of your prescription drugs.
  • Copayments or coinsurance: This is the amount you pay each time you fill a prescription. Copayments are a fixed amount (e.g., $10 per prescription), while coinsurance is a percentage of the cost of the drug (e.g., 20% of the cost of the drug).
  • Coverage gap: Once you and your plan have spent a certain amount on your prescription drugs (in 2023, this amount is $4,430), you enter the coverage gap, or “donut hole”. During the coverage gap, you pay a larger share of the cost of your prescription drugs until you reach a certain out-of-pocket threshold (in 2023, this threshold is $7,050).
  • Catastrophic coverage: Once you have reached the out-of-pocket threshold, you enter catastrophic coverage. During catastrophic coverage, you pay only a small copayment or coinsurance for your prescription drugs.

The Difference Between Part D and Medicare Advantage

Medicare Advantage (Part C) is an alternative to traditional Medicare (Parts A and B). These plans are offered by private insurance companies and provide all the benefits of Medicare Parts A and B, as well as additional benefits such as prescription drug coverage, vision, dental, and hearing services.

Part C plans are not solely focused on prescription drug coverage and have different cost-sharing structures, premiums, and deductibles than Medicare Part D plans. In some cases, Medicare Advantage plans may offer more comprehensive coverage.

When choosing between these two options, it’s important to consider your individual healthcare needs and budget. If you take a lot of prescription drugs, a Medicare Part D plan may be a better option for you. If you want more comprehensive healthcare coverage, including prescription drugs, a Medicare Advantage plan may be a better option.

Get Enrolled in Medicare Part D At No Extra Charge

If you’re looking to enroll you may want to consider using Absolute Best Insurance. We are a company that provides licensed, independent agents who can help you enroll at no extra charge.

Using Absolute Best Insurance can be helpful if you’re confused about the enrollment process or have questions about which plan is right for you. Their licensed agents can help you understand the different plans available in your area, as well as their costs and benefits. They can also help you enroll in a plan and assist you with any issues that may arise during the enrollment process. To learn more, click here or give them a call at (561) 420-0280.

Absolute Best Insurance is committed to providing excellent customer service and ensuring that you have the coverage you need. They have many satisfied customers who have used their services to enroll in Medicare Part D.

Contact Us Today!