Medicare Part D

Medicare Part D

You could actually be eligible for Medicare Part D or coverage for prescription drugs if you are eligible for Medicare Part A or/and Part B. You need not worry about your income level for being eligible, nor any physical examinations are required. You are eligible despite of having health issues or you are using a lot of prescription drugs.

Medicare Part D is mostly voluntary. In case you are receiving your drugs from Medicaid, you can receive them from Medicare as well as soon as you become eligible for Medicare. You are surely required to take a Medicare Part D coverage, even if you do not take up any other similar prescription drug coverage. Not taking any prescription drug coverage calls for tax penalty. It will add to your premiums for as long as you are in any health insurance plan. You are eligible to enroll to Medicare Part D only during Open Enrollment.

Medicare Part D applies also in case you are not taking any kind of prescription drugs. Medicare Part D is an insurance and is meant for your protection in time when you are in need of it. In an event where prescription drugs are not needed in near future, you may buy a plan with lowest premium.

There are many cases where your Medicare Part D plan may change the prescription medications. You need to look carefully into the changes notified to you annually to make sure your medications are still under the plan you purchased. The following change pattern is used by the coverage:

  • You need to pay a deductible for your prescription plan, you will have to pay the entire amount towards your prescription drug purchase until you have met with your deductible.
  • Once you have completed the sum mentioned under your deductible, your structure and its terms will ask you to share some more costs towards the plan. This could be simply a copayment that you pay during your pharmacy pickup time. It could also be a coinsurance as a small amount you pay for your prescription drugs.
  • Once your annual maximum limit is reached, you automatically become eligible for catastrophic coverage. That implies you are eligible for minimal payment of copayment and coinsurance in terms of your prescription drug purchase.

Enrollment into Medicare Part D and Eligibility
As has been mentioned in the beginning, Medicare Part D or prescription drugs eligibility primary conditions are:

  • You have Medicare Part A and/or Part B
  • You live within the service area where prescription drugs coverage is available

In case you are eligible for prescription drugs coverage In Medicare, you can purchase a single medicare Part D or Part C at certain times:
Initial Enrollment Period (For Par D)- This is the time when you get your first prescription drugs cover from Medicare. This period usually overlaps from the time you first become eligible at the age of 65. In case you are eligible through disability for Medicare, your eligibility will begin three months prior to your Medicare disability time. In case you get benefits from Railway Retirement Board or Social Security, this eligibility may start even 7 months before your Medicare eligibility period.
Annual Election time Frame (October 15- December 7)- Every year during this time, you are eligible to change your plan in Medicare. You may move out of from your Medicare Part C and come back to Medicare Part A and Part B. You can also change to another more conducive Medicare Part D (prescription drugs plan). However, you cannot, in this period, make other smaller changes to your existing Medicare Part D plan.
Medicare Advantage Period of Disenrollment (January 1 – February 14)- If you have a Medicare Part C plan and wish to change your mind, you may use this time frame to come out of the Medicare Part C plan and return to Medicare Part A and Part B. You may enroll in your Medicare Part D plan during this time. However, no changes on your existing Medicare Prescription Drug plan may be done during this time.