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Medicare Part D Insurance And Seniors

Updated on September 16, 2020

How It Works

Anyone receiving Medicare is eligible to enroll in a Medicare Part D drug plan. Enrollment isn’t mandatory but, like any type of insurance policy, it can come in handy for anyone taking expensive prescription medications. The first opportunity that Medicare beneficiaries have to enroll in a Medicare Part D plan is when they turn 65. After that, there is an open enrollment period every year from November 15 through December 31. Enrollment can be deferred for anyone who has coverage through another source but, if not, a penalty may be assessed for late enrollment. After signing up for a plan, seniors pay about 25% of the cost of their drugs and the insurance company pays the remaining 75%.

Changes To Part D

The biggest change to Medicare Part D is the planned disappearance of the “donut hole” or coverage gap. The donut hole occurs when the total cost of prescription drugs reaches a certain amount and insurance coverage stops. In 2010, that amount is $2,830. The recent health care legislation has begun a process to close the donut hole, starting with a $250 rebate that will be mailed to anyone entering the donut hole in 2010. In 2011, the cost of branded medications in the donut hole will be subsidized by 50%. Changes will continue until 2020, when there will no longer be a coverage gap. At that point, various subsidies will mean that beneficiaries pay 25% of their drug costs, as they do with full coverage.

Advantages of Medicare Part D

Choosing A Medicare Part D Plan

Most states have dozens of different Medicare Part D plans available to residents on Medicare, each sold by a private insurance company. Plans have a formulary, which is the list of drugs covered, and the costs of the plans vary, as well. The simplest way to choose a plan is by using the prescription drug plan finder that can be found at the Medicare.gov website. This tool allows users to enter their prescription medications, including details like dosage. The result is a list of drug plans with specific information on the monthly premium of plans, deductibles and drug costs. The tool also will also tell users if and when to expect to enter the donut hole and what the cost implications will be.

 

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