Medicare Part D, for most people, is the most complex and confusing “part” of Medicare. Whereas Parts A & B are pretty straight-forward, Medicare Part D has many intricacies that cause headaches and stress for even the most educated and patient Medicare consumers. This article is intended to be a compilation of important reminders about Part D that will allow you to make an informed decision when it’s time to choose a Part D plan. We’ll look specifically at the questions of when to enroll, what to compare, and which plan to choose.
First of all, the question the is foremost in your decision-making process is when to enroll in a Medicare Part D plan. The easiest answer is that, for most people, you should enroll when either one of two things happens – you turn age 65 (assuming you don’t have other, creditable coverage for prescriptions) or you lose your existing, creditable drug coverage. Medicare charges a “late enrollment penalty” if you neglect to enroll in a Part D plan when you are first eligible. This penalty is 1% of the Medicare standard Part D amount, per month that you don’t enroll after your initial enrollment penalty. This is added on to the premium when you do enroll – and this penalty stays with you as long as you are on Part D. So this a definite downside of not enrolling in at least a basic plan when first eligible, even if your medication needs are minimal.
After that initial enrollment period, you can enroll in, or change, your Part D election during the annual enrollment period, which currently runs from October 15 to December 7 each year.
The 2nd question regarding Medicare Part D is what to compare when looking at the different Part D options. When you are preparing to enroll in a Part D plan, there are several things you will want to do. First of all, it is essential to compare the plans based on any current medication needs. There are usually 25-40 plans in each county, and the coverage/co-pays on these different plans varies considerably. The most effective way to compare the plans is to use the Medicare plan finder which is on Medicare.gov. On this site, you can pull up plans for your county, enter your medications and compare based on the overall annual costs – co-pays, etc. On the comparison that the Medicare website generates, you can view an estimated annual costs, which includes your premium, any deductible, and co-pays for the medications that you have entered. This bottom-line number is what we would recommend that you use to choose a plan in most cases.
That brings us to the next question of which Part D plan to choose. As mentioned above, we would recommend comparing the plans based on current medications usage and choosing a plan that gives you the lowest cost for your medications overall. Other factors to consider when comparing the options are where you can use the plan – most plans have networks and/or preferred pharmacies – and “donut hole” coverage. The Medicare “donut hole”, or coverage gap, is a feature of Medicare prescription drug coverage. Different plans have different ways of handling the “donut hole”, which could be important to you if you are on multiple medications or medications with a high retail cost.
Choosing the right Medicare Part D plan can literally be the difference of thousands of dollars. Plans vary greatly. Medigap-Quote.com does not sell Part D plans, but we do provide the Part D comparison service through Medicare’s plan finder for our Medicare supplement clients on an annual basis (plans change each year). If you have questions or would like to compare your Medicare supplement or Part D plan, feel free to contact us online or call us at 877.506.3378.
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