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!

Brian Carter

Brian Carter

Brian Carter has been in the health field since 1999, and was a medical terminology teacher at the Master's degree level. He's also a marketer, stand up comedian, and an abstract painter. Brian has a lot going on, but his passion is Medicare and helping seniors with their Medicare and other health insurance. Brian learned from his grandma that how you live your senior years matter, because you may live a lot more of them than you expect... she lived to be 105 years old, and despite being a farmer and school teacher, she lived frugally enough to be able to give to others. She also received a Governor's award for volunteer service at her local Kokomo, Indiana hospital. His mom was a special education teacher, so he had plenty of good role models for living a life of service to others. Brian grew up in Ohio, lived in San Diego, but loves Charleston, SC the best. It's his favorite city in the world. He has a deep love of the land, the rivers, and the people who call this area home. When asked how he feels about seniors, Brian says, "I love old people... I married one! Don't tell my wife I said that."