What is Medicare Part D Prescription Drug Coverage?

Medications are a big part of your Medicare insurance plan. Original Medicare (Parts A and B) don’t cover all prescription drug cost and for Medicare recipients needing prescription drug coverage, Medicare Part D can be purchased in two ways:

• as a standalone plan intended to supplement Medicare Parts A and B;
• or it can accompany a Medicare Supplement Plan.

You should enroll in Medicare prescription drug coverage when you are first eligible for Medicare. You can also make changes during the Medicare Advantage and Prescription Drug Plan Annual Enrollment Period, which runs from October 15 to December 7 each year.

Our personal licensed sales agents are ready to talk with you about Medicare Part D. We independently shop up all of the available insurance companies and compare rates and to find the best plan suiting your needs.

Which Prescriptions are covered?

Most Medicare drug plans have a formulary, which is a list of covered drugs. Generic drugs and brand names will be covered in the formulary and includes at least 2 drugs in the most commonly prescribed categories and classes. This ensures people with different medical conditions can get the prescription drugs they need.

The formulary might not include a specific drug that has been prescribed to you, but most of the time a similar drug will be available. If you or your doctor believes none of the drugs on your plan’s formulary will work for your condition, you can ask for an exception.

A Medicare drug plan can make some changes to its formulary during the year if it follows guidelines set by Medicare. Your plan may change its drug list during the year because drug therapies change, new drugs are released, or new medical information becomes available so it is wise to keep this in mind if you take on a new prescription during coverage.

It is possible that plans may remove drugs from their formularies after the Food and Drug Administration (FDA) considers them unsafe or if their manufacturer removes them from the market. Plans meeting certain requirements also can immediately remove brand name drugs from their formularies and replace them with new generic drugs. They can also change the cost or coverage rules for brand name drugs when adding new generic drugs. If you’re currently taking any of these drugs, you’ll get information about any specific changes.

For other changes involving a drug you’re currently taking that will affect you during the year, your plan must do one of these:

• • A 30 day  written notice is given before the date the change becomes effective.
  • At the time of refill, provide written notice of the change and at least a month’s supply under the same plan rules in effect before the change.

For a free phone consultation, click on this link, complete the form and one of our Business Consultants will contact you.