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Medicare Part D

Prescription drug coverage

Medicare Part D Offers Prescription Drug Coverage in West Orange, NJ

If you’re looking for prescription coverage plans, Medicare Part D can be a standalone option or combined with a Medicare Advantage plan (Part C). Certain plans will only work with specific pharmacy networks or provide mail-in orders for discounted prices. Prescription coverage plans are available from Medicare-approved private insurance companies. Your options will vary based on where you live. Also, keep in mind that Medicare Part D costs and coverage are above the standard Medicare plans. You must enroll in Part A or B to get a Medicare Part D plan.
Medicare Part D Plans West Orange NJ

What Medicare Part D Covers:

  • The most commonly prescribed types of drugs per federal standards.
  • Specified brand name and generate drugs found on the drug list.
  • Commercially available vaccines that aren’t covered under Part B.

Stages of Coverage

When you enroll in prescription drug plans, coverage follows four stages. You will pay some of the cost of your medications during each stage to a specified limit. This cycle renews each year.

  • You pay your prescriptions in full until you reach your annual deductible.
  • Upon starting coverage, you are responsible for copays and coinsurance to a set annual limit.
  • During the coverage gap, you will pay a percentage of your costs up to an annual out-of-pocket limit.
  • Annual limits can change each year.
  • If you qualify for catastrophic coverage, your copay is reduced for the remainder of the year.

Current Medicare Part D Costs

  • Medicare Part D costs vary and can even change from one year to the next.
  • If you enroll in Part D late, you may have to pay a premium penalty.
  • If you have a Part C plan, it may include drug coverage.

Deductible

  • Your deductible can change each year.
  • For 2020, the maximum deductible was $435.
  • Some plans don’t have a deductible.
  • There may be different deductibles for various tiers.

Copay

  • You may need to pay a copay for your prescriptions and refills. The amount will vary.

Coinsurance

  • Your plan may have set coinsurance rates that apply to certain drug tiers or drugs.
  • The cost of brand name and generic drugs in 2020 is 25 percent of the cost.
Medicare Part D West Orange NJ

Part D may charge a premium penalty if you don’t sign up when you are first eligible, unless you qualify for a Special Enrollment Period.