What Medicare plans cover prescription drugs?
Neither original Medicare, nor Medicare supplemental plans (“Medigap“) include prescription drug coverage, so you need to enroll in a separate PDP (Prescription Drug Plan, also called ‘Medicare Part D’ plan), if you want to be covered for medication. Another option would be to enroll in a Medicare Advantage plan with prescription drug coverage (also referred to as MA-PD).
How Does Medicare Part D Work?
Medicare Part D insurance is the government program and good for anybody with an original Medicare health insurance policy. Even in case you do not require a large amount of medications now, it is really important that you think about joining a Medicare prescription drug plan, as your need for prescription drugs may change in the future.
Part D will help cover the costs for prescriptions you have to take on a regular basis, and also protect you against devastating drug bills in case of a severe illness. Choosing a Medicare prescription drug insurance policy will help all those on Medicare having problems paying off prescriptions.
Medicare insurance Part D is administered through private insurance carriers, authorized by Medicare. Included drugs and costs may vary greatly for each plan and region, so it is a good idea to review your options diligently in order to obtain the right policy for you.
Part D Formulary And Tiers
At a minimum, Medicare Part D prescription drug plans must provide a standardized degree of insurance coverage. Prescription medications covered by Medicare Part D are generally divided into four price levels called ‘tiers’. Generics together with low-cost medicines are low-tier drugs ; branded and costly prescription drugs are usually higher tier levels.
Unfortunately, there is little uniformity among Part D plans, which makes it even more complicated to select a policy. As an example, a prescription drug might be part of the 2nd tier for one plan, but on Tier 3 in another plan, yet cost less in the 2nd plan policy. Some plans also make use of names instead of numbers, which makes it even harder to compare them.
A plan’s formulary is a directory of prescription medications the plan insures. If a prescription you take isn’t on a plan’s formulary, you may want to get a different plan. It is best to compare the plan’s formulary versus the medications you need to find out if your medicines are insured and how well they are covered. You cannot assume all formularies are created equal! Often you will discover your prescription drug is not included. Moreover you will discover a drug is in different tiers in different plans.
Part D Costs And Participating Pharmacies
The majority of programs have a system of drug stores you are required to utilize to get the most beneficial cost. When you visit a drugstore that’s not part of your program’s network system, you may need to spend considerably more for your prescription medications. So you need to confirm your local drugstore is in the provider’s network.
All drug plans cost a regular monthly premium which will vary by plan. You pay the monthly premium on top of your Medicare Part B insurance premium. If you have a Medicare Advantage Plan such as a HMO or PPO plan that has drug coverage, your monthly premium for the Advantage plan could include prescription drug insurance coverage – check with your insurance provider to find out what is included in your policy.
