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Part D

Prescription Drugs

These Plans help to not only cover prescription drugs but includes many recommended shots and vaccines.

Golden Meadowlark Insurance is here to help with all of your Medicare needs.  One of the services we provide is to help you find a Part D plan that fits your specific needs.

What is Part D?

Medicare drug coverage helps to pay for prescription drugs that you may need.  These plans our offered by private insurance companies that are contracted with Medicare.  There are two ways to get a drug plan.

  1. Stand alone Part D:  These plans add drug coverage to original Medicare, and also to some types of Medicare Advatages (PFFS and MSA).

  2. Medicare Advantage (Part C): These plans can bundle all your Part A, B, and D in one plan.

When Can I sign up?

If you have Medicare Part A or Part B you will be able to sign up for Part D.  There are three main enrollment periods when you may sign up for Part D.

  1. Initial Enrollment Period:  Most people sign up for Part D when they become eligible for Medicare.  This is a seven month window that starts three months before your 65th birthday month, includes your 65th birthday month, and continues for three months after your birthday.

  2. Annual Election Period:  During October 15- December 7 you can change or sign up for Part D.

  3. Special Enrollment Period:  In special circumstances you may qualify to change your Part D.  An example would be if you moved out of your Part D region.

Do I really Need a Part D?

Here are two reason why you might want a Part D even if you do not take any prescriptions.

  1. Late Enrollment Penalties:  If at any time after your initial enrollment period is over,  you have a period over 63 or more days in a row when you don't have part D or creditable drug coverage you may have a late enrollment penalty.  In most cases you will have to pay that penalty for as long as you have Part D. 

  2. Enrollment Periods:  Lets say you are past your initial enrollment period and didn't sign up for Part D.  Then you get prescribed some expensive medication.  You cannot just go sign up for a Part D plan.  You would have to wait until the Annual Election Period or a Special Enrollment Period to enroll in a Part D.  This could be months away and you would have to cover the cost of the medication without a Part D plan.

How Does My Part D Work?

Part D Plans have four different stages.  In each stage you may have a different cost for the exact same type of medication depending on the stage your are in.

  1. Deductible:  You will pay the full price of your medication until the deductible is met.

  2. Initial Coverage:  You will pay a copay for your medication based on the tier of the drug.

  3. Coverage Gap (Donut Hole):  After the total drug cost reaches $5,030,  you will be responsible for 25% of the cost of your drugs.

  4. Catastrophic Coverage:  After you reach $8,000 of out of pocket cost for covered drugs, your plan pays the full cost for your covered Part D drugs.

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