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You’re turning 65 and concerned about Medicare Benefits. This series is titled, Medicare, What's it All About? This is video 3 of 3, “Part D Prescription plans, do I get coffee with the donut hole”.
Part D is prescription drug coverage that is offered through private Medicare-approved insurance companies. Every Medicare Prescription Drug Plan has its own list of drugs, called a formulary, for which it will provide coverage. A formulary is divided into different tiers according to the cost of the drug: drugs on a lower tier will generally have lower copayments than drugs on a higher tier.
As Parts C and D are provided by private insurance companies, the monthly premiums of these policies depend on the extent of their coverage and can vary between companies.
However, although the cost varies from plan to plan, the payment structure for Part D often can create a gap in coverage. Essentially, you pay monthly premiums for Part D all year, and with most plans you pay 100 percent of your drug costs until you reach your deductible amount. After your deductible, the cost of your drugs is split between you and your plan. However, once you and your plan have spent $3,310 on covered drugs, you’ve entered the coverage gap, and now will have to pay 58 percent of the price of generic drugs and 45 percent of the price of brand-name drugs. You will not exit the coverage gap until you’ve spent out-of-pocket $4,850 (Troop – true out of pocket expenses) on prescription drugs. At that point, you will qualify for “catastrophic coverage” and will only have to pay a small copayment for covered drugs for the rest of the year.
You might have heard that Medicare and Social Security referred to as entitlements. Well you earned them with all your years of hard work. They are not gifts from the government.
Grab your copy of “Turning 65 – The 5 Medicare Key Tools.
You’ve been bombarded with tons of material in your mailbox and on TV. The terminology can seem confusing. This guide can help you. Know when you should sign up for Medicare? Why being early is better. You have options regarding your Medicare coverage. Do you want co-pays, deductibles, and choice of doctors? Learn the following: how to enroll in Medicare. Enrollment is not always automatic. What do all those Parts and Letters mean? Who pays for what? Why you need Medicare.
You may not know this but there is a perk to turning 65 and it's called Medicare. I know who would have thought that. In today’s world it's pretty good medical coverage. And in the videos we want you to learn how to maximize your benefits.
Don't forget to get your Free copy of "Turning 65 – The 5 Medicare Key Tools.
What you need to know about Medicare. A guide, to aid you in understanding the basics of Medicare Parts A, B, C & D and a whole lot more.
Frequently Asked Questions
What is Medicare supplement insurance?
Medicare supplement (Medigap) insurance is sold by private insurance companies and helps cover the costs that Medicare doesn't cover.
Can I purchase a Medicare supplement insurance plan?
You are probably eligible to purchase a Medicare supplement insurance plan if you are enrolled in Medicare Parts A or B.
If you are in your Open Enrollment period, insurance companies that offer Medicare supplement plans must allow you to purchase.
Open enrollment is over. What now?
You may still apply for Medicare supplement insurance at the company of your choice. However, they will review your medical history and current health using their application process.
How do I pay for Medicare supplement insurance?
You pay the insurance company that provides you coverage. You can typically pay for your insurance monthly, quarterly, semi-annually, or annually. This cost is in addition to your Medicare Part B expense.
Will my premium ever change?
It is likely your premium will change with the rising cost of healthcare claims. Each year, you may be subject to both an age increase due to your birthday and an increase due to the medical claims the insurance company has to pay out for policies like yours.
Does Medicare supplement insurance limit my choice of doctor?
No, you may select any doctor that accepts Medicare.
Does Medicare supplement insurance cover prescriptions?
No, Medicare supplement insurance does not cover prescription expenses. You will need to enroll in a separate Medicare Part D drug plan for coverage.