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.
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.
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
- 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.
