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Medicare Part D Basics

Medicare Part D is the name for the Medicare Prescription Drug Program which began in 2006. Under Part D, the Centers for Medicare and Medicaid Services (CMS) contracts with private insurance companies to provide prescription drug benefits to Medicare beneficiaries.

In order to get benefits under Medicare Part D, Medicare beneficiaries must enroll in one of the Medicare Part D plans offered by these private insurance companies (there are many plans available to choose from). Beneficiaries must pay premiums, deductibles and co-payments set by the plans. The plans also receive payments from CMS.

Over half of Original Medicare (Parts A and B) are enrolled in a Part D plan. Of those enrolled in Part D, nearly 40% qualify for assistance with premiums and receive a Low Income subsidy (LIS). There is a coverage gap in this plan. Many people who qualify for LIS do not take advantage of this assistance, so it is important to factor in your income when making a decision.

Steps to making a decision on Medicare Part D

Analyze your current annual prescription drug costs.  You need to determine what you would for your prescriptions if you had no insurance.  Check with your pharmacist to get an accurate cost.

  • Medicare Part D coverage is only good up to $2,250 for most plans. After your expenses exceed this amount, you have to continue paying monthly premiums but get no coverage until your costs go above $5,100.
  • This gap in coverage is sometimes referred to as a “Donut Hole”. In order to avoid this gap, and sort through the many plans available you can get our help.
  • If you already have a Medicare Supplement policy with prescription drug coverage, you can keep that policy or join a Medicare prescription drug plan.
  • A Medicare prescription drug plan is an option, not a requirement.
  • Let Medigap4Seniors help you choose the insurance company’s plan that’s best for you. Take a minute to fill out the Medigap Quote request. Indicate your desire to learn about Medicare Prescription Drug coverage. You can also call us with 1-888-502-5553. We have experts waiting to help you with your prescription drug coverage plans.
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