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Important Points to Know about Obtaining Medicare Drug Coverage
When enrolling for Medicare you can get coverage for prescription drugs. Medicare drug coverage is available through private insurance companies approved by Medicare. There are different ways to obtain the coverage with associated costs that vary depending on other coverage used with this plan. It is important to know how this works with other insurance you have in order to get the best coverage. Here is what you need to know about this option.
How Do You Get Coverage
You have two options to get drug coverage including through Medicare Part C Advantage Plan or through Part D Prescription Drug Plan. The most common way is through Part D. This plan can be used with original Medicare and other plan option such as a Medical Savings Account (MSA) or Medicare Cost Plans. Part C or Medicare Advantage Plan includes using a PPO or HMO along with benefits similar to Part A and B. You may be required to sign up for Part A and B in order to obtain Part D with Part C. Medicare drug coverage options may vary and could change depending on what Part C covers.
Associated Costs and Getting Help
Your income will determine how much you pay toward prescription drugs. If you receive Social Security you can have costs deducted from your Social Security payment. You may be required to satisfy an annual deductible before the drug coverage starts to pay. You may be required to pay a copay or coinsurance after paying a deductible (if your plan has this requirement). There are drug plans with different tiers that show how much you could pay depending on related costs.
Generic drugs may have cheaper copay than name brand. The copay can be anywhere from a few dollars to $10 or so. The coinsurance is roughly a percentage of what the beneficiary pays before Medicare insurance covers costs. An example may be 20 or 25 percent. When you pay for drugs you are paying for a month supply unless stated otherwise. There is potential for out-of-pocket costs to be paid by the beneficiary if the insurance does not cover the cost, but in few cases this is rare.
Additional Tips on Drug Coverage
You can get help paying for Medicare drug coverage if you qualify. You may need to provide proof of documentation to show your eligibility for assistance. Such options may allow you to pay just a few dollars for medicine. You can obtain help when you are receiving medication and before your supply runs out for the month. The amount you pay for your plan varies based on drugs used, plan option, where you go to obtain prescriptions, if the drug is on the formulary approved by Medicare, and whether you qualify for assistance in paying for drug costs. You may qualify for assistance by your state if you receive Medicare Part A and/or Part B coverage. Enroll for coverage during the initial period to avoid paying penalites.
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