On its own, Medicare doesn’t cover pharmaceuticals. Eliminate surprises and read these Medicare tips for pharmacy customers.
#1 Original Medicare itself does not cover prescription drugs at all!
You need a Part D (with original Medicare or a medsupp) or an MAPD (Medicare Advantage plan with Prescription Drug coverage) for Medicare prescription coverage.
#2 Part D costs more for people who make more money.
Read up about IRMAA here. This is something your financial planner will want to know. And you will need to budget for in your plans.
#3 There are lifetime penalties for signing up late for a Part D plan.
Most people should sign up as soon as you can, unless they are working past 65 with employer health coverage.
#4 Medicare costs increase every year to keep pace with inflation.
What’s more, health and drug plan rates may increase so that insurance companies can stay profitable. It’s important to budget for these things when you plan your retirement.
#5 There are zero-premium plans with out-of-pocket maximums.
These are the Medicare Advantage Prescription Drug (MAPD) plans. Some people prefer to go with a Medicare Supplement (Plans F-N) and a Standalone Prescription Drug plan. But if premiums are the main financial concern, an MAPD may be best.
#6 You may qualify for Extra Help, which gives you prescription discounts.
Extra Help, formerly known as the Low Income Subsidy (LIS), assists people with lower incomes to be able to afford the medications they need.
#7 If you’re on Medicaid, you may qualify for even better plans with lower costs and more benefits.
The MAPD options are even better for what are called Dual Eligible enrollees (the dual refers to Medicare and Medicaid). What’s more, if you qualify for this, you can change your plan once a quarter in the first three quarters of the year. People with standalone PDP’s can only change their drug plans annually, Oct 15 – Dec 7, unless they qualify for a Special Enrollment Period, or it’s their Initial Enrollment Period.
To schedule an appointment to find out more and get help with your prescription drug plans, contact us!
