How much do I pay?
Medicare Part D is administered by private insurance companies. Each company determines what it’s monthly premium will be along with what drugs are on formulary, on which tier, and copay amounts.
How much do my prescriptions cost?
In addition to the monthly premium you will pay a copay or coinsurance each time you pick up a prescription. What you will pay for prescriptions will depend on the drug, if the plan has a deductible, what tier each drug is on, what phase you are in (deductible, initial coverage, coverage gap, catastrophic), what pharmacy you use, and if you qualify for Extra Help.
What is the coverage gap (donut hole)?
Most Medicare Prescription Drug Plans have a coverage gap (also called the “donut hole”). This means there’s a temporary limit on what the drug plan will cover for drugs. Not everyone will enter the coverage gap. The coverage gap begins after you and your drug plan have spent a certain amount for covered drugs. In 2016, once you and your plan have spent $3,310 on covered drugs, you’re in the coverage gap until you have spent $4850 out of pocket. This amount may change each year. Also, people with Medicare who get Extra Help paying Part D costs won’t enter the coverage gap.
I don’t understand all the different terms:
Medicare Part D has a lot of terms you need to understand. AARP actually has an excellent glossary of the terms at http://www.aarp.org/health/medicare-insurance/info-11-2009/Medicare_partD_guide_glossery.html
How much is the Part D penalty?
The cost of the late enrollment penalty depends on how long you went without Part D or creditable prescription drug coverage. Medicare calculates the penalty by multiplying 1% of the “national base beneficiary premium” ($34.10 in 2016) times the number of full, uncovered months you didn’t have Part D or creditable coverage. The monthly premium is rounded to the nearest $.10 and added to your monthly Part D premium. The national base beneficiary premium may increase each year, so your penalty amount may also increase each year. You may owe a late enrollment penalty if you go without a Medicare Prescription Drug Plan (Part D), or without a Medicare Advantage Plan (Part C) (like an HMO or PPO) or other Medicare health plan that offers Medicare prescription drug coverage, or without creditable prescription drug coverage for any continuous period of 63 days or more after your Initial Enrollment Period is over.
How do I choose which plan to sign up for?
If you want to figure it out on your own I would definitely use the Medicare plan finder. That way is much easier than trying to figure it out using each companies information. OR if you live in Northeast Ohio I would do it the easy way and call Nancy at 216-287-8832 for a free consultation.
Medicare Part D information
https://www.medicare.gov/part-d/
Coverage gap (donut hole)
https://www.medicare.gov/part-d/costs/coverage-gap/part-d-coverage-gap.html
Prescription Assistance Program
https://www.medicare.gov/pharmaceutical-assistance-program/
Great site to find saving tips
