Medicare Part D

A Medicare prescription drug plan is a smart way to manage the cost of the medications you take now—and those you may need in the future. If you’re entitled to Part A and/or enrolled in Part B of Original Medicare, you’re eligible to join a Part D plan; however, when you enroll affects your effective date and premium. Truck Insurance Specialists can help you understand your eligibility and explain to you the Medicare Part D plans that are available.

Medicare Part D Plans

  • Are only offered by insurance companies
  • Can be purchased as a standalone plan
  • Have a monthly premium in addition to any Medicare premium you already pay.
  • Can be purchased in conjunction with a Medicare supplement plan
  • Maybe included in a Medicare Advantage plan

Medicare Part D Resources

Prescription drug coverage for seniors changes at 65. Why? Because at 65, seniors are finally eligible for Medicare. It’s something they’ve paid into for decades while working. However, prescription drug plans for seniors is not part of Original Medicare. Getting the prescription drug coverage you enjoyed while working will take a little more arranging.

Covering the Medicare Part D Donut Hole

For most Americans, the Medicare Part D donut hole is a coverage gap that could make all the financial difference when it comes to paying for prescription drugs. While you are in this gap in 2018, you are responsible for paying for 35 percent of brand-name drug costs out of pocket until you reach a certain limit. In 2019, that amount is lowered to 25 percent.

A Part D plan’s coverage works like this.

  1. You have to pay for your monthly premiums throughout your plan’s coverage year.
  2. Before you reach your deductible, you will have to pay all of the cost of your prescription drugs.
  3. Once you’ve reached your deductible, you’ll only pay a copay or coinsurance for your prescription drug costs, leaving the remaining amount for your Part D plan to cover. You will need to do this until you’ve reached the limit. (In 2018, the limit is $3,750.)
  4. Once this limit has been reached, you will hit the coverage gap (or donut hole). During this time, you will be responsible for 35 percent of your prescription drug costs until you hit your yearly out-of-pocket maximum limit ($5,000 in 2018). In 2019, this cost will be only 25 percent.
  5. When you finally exceed the annual out-of-pocket maximum, you will begin receiving catastrophic coverage. You may get your prescription drugs completely covered or at a much smaller cost for the remainder of the year.