Outside of Medicare Part A and Part B, also known as Original Medicare, there are three other supplemental Medicare programs you can choose from during open enrollment. These supplemental plans provide additional coverage to help reduce your out-of-pocket costs for health insurance after the age of 65. As we are currently in an open enrollment period until December 7th, here is what you need to know about Medicare Part D enrollment, one of the supplemental Medicare options available.
Medicare Part D Plans for Prescription Drug Coverage
Different Medicare Part D plans will provide various coverage depending on the formulary set by each plan (see The Cost of Medicare Part D). Plans with a deductible require you to pay the total cost amount until the deductible is reached. Then Medicare Part D will enter coverage stages. Generally speaking, the stages are initial coverage, the coverage gap, and catastrophic coverage through the end of the year. During the coverage gap, the average amount paid is 65% of the generic drug price and 45% of the brand name drug price.
The Cost of Medicare Part D
Depending on when you perform Medicare Part D enrollment, your premium may rise or you may need to pay a penalty if you are late to enroll. Monthly premiums for each individual plan are set in October and will vary depending on the plan formulary. The formulary for Part D includes a list of drugs in different pricing tiers. This is why it is important to write down a list of your medications and provide to your Medicare insurance professional.
When to Enroll in Part D
During the current open enrollment period, you can enroll in Part D for the first time or change between Part D plans from different insurance providers. You can also choose to drop your coverage entirely. If you just want drug coverage but don’t want Part D, you also have the option to enroll in a different Medicare Advantage plan that offers drug coverage, or vice versa.
If you cannot perform Medicare Part D enrollment before December 7, there is also the Medicare Advantage Disenrollment Period from January 1-February 14. During this time, you can leave a Medicare Advantage plan to switch to Original Medicare. If you do switch to Original Medicare, you have until the end of the Medicare Advantage Disenrollment Period to join a Medicare Prescription Drug Plan.
In both of these cases, coverage begins the first day of the month after the plan receives your enrollment form.
How to Begin Medicare Part D Enrollment
Before you can receive Part D coverage, you will first need to enroll in Medicare Part B to eligible. You then need to speak with a Medicare professional who will be able to evaluate your medications and your budget to provide the most coverage in a cost-effective Medicare Part D plan. A Medicare professional will also help you shop the market to find the best plan as opposed to a single insurance provider who has limited plan options.