Published in February 28, 2020

Medicare plans have helped millions of Americans afford the medical attention they need. When applying for Medicare, notice that there are separated into parts. These parts all come together to provide you with the health care coverage necessary to assist in your medical needs. Its coverage plays an important role in containing medical costs as you age. However, these benefits don’t cover everything. Certain parts of this government program are not included in insurance, such as Medicare Part D.

Part D is prescription drug coverage provided by Medicare-approved private insurance companies. Because it’s an optional benefit, these plans will have certain caveats. In this guide, you will learn about Medicare insurance plans, how to compare plans, costs and more.

What are Medicare plans?

Medicare is a government assistance program that provides health insurance plans, giving health care coverage to senior citizens or disabled persons. There are several kinds of coverage plans applicants can receive, depending on his or her needs. Part A and B, also known as Original Medicare, covers hospital insurance and medical insurance. Next is the Medicare Advantage (MA) plan, also known as Part C. When you compare Original and MA plans, the MA plans will have Parts A and B included. These two differ in terms of who provides the coverage like how private companies provide MA plans approved by Medicare. The last insurance plans is Part D. In order to get prescription drug coverage, you need to choose a prescription drug plan from Medicare and will need to pay for a monthly premium. These plans are also run by Medicare-approved private companies.

Eligibility for Part D Medicare

In order to be eligible for Part D, or Medicare part plans in general, you need to meet specific requirements. You can only enroll during certain times of the year and not doing so can result in a late enrollment penalty and must fall under one of the three categories to qualify:

• Be 65 years of age or older

• Disabled

• Have end-stage renal disease

These are qualifiers for Parts A and B, which you will need to receive Part D. Once you have been found eligible for Parts A and B, picking between Original Medicare or obtaining an MA plan is the next step. Choosing Original Medicare means you have to pay for a monthly premium for prescription drug coverage. While choosing an MA plan may mean Part D is already included in your plan.

Part D Medicare Coverage and Costs

The kind of coverage and price can vary from plan to plan. All plans for Part D are offered by private companies. Generally, Medicare Part D will cover self-administered drugs, which are included in the drug formulary of the insurance plan. Part D plans will also cover generic drugs, which are copies of brand-name drugs approved by the Food and Drug Administration (FDA).

The coverage for the drug cost will depend on which tier these drugs land on in the prescription drug plan, which can be set up in three tiers. The higher the tier, the higher the co-payment and the more well-known the brand will be. There may also be specialty tiers, which have really high cost. In this case, filing an exception can lower the co-payment. For Medicare Part D, the standard plan has changed their costs for benefits. There have been minor increases in the initial deductible, which is up by $20, and the initial coverage limit, which has increased $200. The out-of-pocket threshold has also increased from $5100 to $6,350 for 2020.

Compare Medicare Part D Plans

If you are trying to compare plans, the Medicare website has tools to find Part D Medicare plans for this purpose. For instance, Medicare Plan Finder can be used to sift through plans that work for you. Using your location and personal information, the Plan Finder will look for plans that will suit your medical needs. Remember while comparing choices to see which plans fit with any other health care coverage you already have. Talk to your insurer about how Part D fits in and if you need to make any changes to your current health care plan.