Medicare Part D

Medicare prescription drug coverage (also called Medicare Part D) covers brand name and generic drug prescription costs. To join this program you must either purchase the plan separately or join a Medicare Advantage Plan that includes the prescription drug plan.

These plans make the most sense for people that are concerned with future unexpected drug costs or for people that are currently using a large amount of prescription drugs.

However it has been estimated that if you spend as little as $70 per month ($840 per year), you can still save money with Medicare Drug Plans.

Medicare Part D Costs

If you decide to join you will pay a monthly premium and a yearly deductible. You will also have to pay a portion of the costs of your prescriptions such as co-payments and deductibles. Here is a breakdown of a typical plan

Monthly Premiums range from $35 to $40.
The annual deductible is approximately $280.
Cost of Prescriptions ($275-$2510) -25% will be paid by you and the remaining 75% will be paid by Medicare.
Cost of Prescriptions ($2,511-$5,726)-100% will be paid by you.
$4,050 annual out-of-pocket limit-You will pay the greater of 5% of the drug costs or $2.25 for generic drugs and $5.6 for brand-name drugs. Medicare pays 95% of the drug costs or the remaining balance of the drug costs (which ever is smaller in total dollar value).

Medicare Drug Plans Eligibility

You may sign up three months before the month you turn 65 up until three months after you turn the age 65. If you don’t sign up during this initial eligibility period then you may have to pay a penalty. If you didn’t sign up during the initial period your next opportunity will be from November 15, to December 31, of the current year.

Medicare Part D Drug Coverage

These plans cover most drugs that fall into these categories:

Antidepressants
Antipsychotics
Anticonvulsants
Antiretrovirals (Aids treatment)
Immunosuppressants
Anticancer.

Drugs that are not covered

The following types of anti-anxiety and anti-seizure drugs are not covered:

Barbiturates – Including:

Pentobarbital (Nembutal)
Secobarbital (Seconal)
Amobarbital (Amytal)
Phenobarbital (Luminal)

Benzodiazepines- Including:

Xanax
Klonopin
Valium
Ativan

The majority of vitamins and minerals are not covered. Prenatal vitamins and fluoride prescriptions are generally included.

Prescription drugs used for the following ailments are not covered:

Anorexia
Fertility
Weight gain or weight loss
Relief of cold symptoms
Cosmetic or hair growth supplements.

Pharmacy Restrictions

Most Medicare drug plans have a large network of pharmacies ranging from 30,000 to 50,000 locations. In most cases finding an approved pharmacy will not be a problem.

Medicare Part D can help with expensive drug costs. Unfortunately there are many more stressful healthcare costs. Be sure to understand the full Medicare Supplemental Insurance picture before you purchase a Medicare Drug Plan.

Depending on your needs a Medigap or Medicare Advantage Plan could be a better option for you.

If you would like additional information the Medicare Advocacy has an excellent Medicare Part D question and answer section on their website.

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