What is Medicare Part D

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What is Medicare Part D:

Medicare Part D Helps cover the cost of prescription drugs. It is run by Medicare-approved private insurance companies. These plans help lower your prescription drug costs and help protect against higher costs in the future.

Unlike Medicare part A & B, enrollment into Medicare Part D is typically not automatic.

There are 2 ways to get Medicare prescription drug coverage:

Medicare Prescription Drug Plans. These plans are drug coverage only plans and add drug coverage to Original Medicare. They are typically selected along with a Medicare Supplement Insurance Plans.

Medicare Advantage Plans (like HMOs or PPOs). You may get all of your Part A, Part B, and prescription drug coverage through these plans. Medicare Advantage Plans with prescription drug coverage are sometimes called “MA-PDs.” You must have Part A and Part B to join a Medicare Advantage Plan. Not all of these plans offer drug coverage. So be sure to get qualified assistance in enrolling into these plans so you end up with the coverage you expect.

If you have retirement coverage in place, before enrolling in a Part D or MA-PD plan, call your benefits administrator before you make any changes. If you drop your employer or union coverage, you may not be able to get it back. You also may not be able to drop your employer or union drug coverage without also dropping your employer or union health (doctor and hospital) coverage. If you drop coverage for yourself, you may also have to drop coverage for your spouse and dependents. Your benefits administrator should be able to give you guidance regarding changing and enrolling into different drug plans.

No plan covers every drug. Every plan has its own book of covered drugs that are called formulary guides. Many Medicare drug plans place drugs into different tiers on their formularies. Drugs in each tier have a different cost. For example, a drug in a lower tier will generally cost you less than a drug in a higher tier. Be very aware that drug tiers are determined by the plan you are in and are not standardized. You cannot expect a tier one drug, as an example, to remain tier one in a different company. Before selecting a new prescription drug plan, be sure to make sure your drugs are covered, and at as low a tier as possible. 

The benefit information provided is a brief summary, not a complete description of benefits. For more information, contact your plan. 

Limitations, copayments, and restrictions may apply.

Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year.

You must continue to pay your Medicare Part B premium.

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