Medicare Part D is Medicare's prescription drug benefit. If you have Medicare Part A or Medicare Part B, you have the right to Medicare Part D. You may access Part D through a standalone drug plan, a Medicare Advantage plan or you may not need Medicare Part D at all, depending on the other coverage you have.
Standalone Plans
Part D standalone plans work with original Medicare alone or original Medicare and a Medicare Supplement (Medigap) plan. These plans are offered through private companies approved by Medicare. There is a monthly premium, and there are copays and deductibles. Each plan has a formulary that divides prescriptions into tiers, and each tier has its own copay. You can purchase a standalone plan when you first qualify for Medicare and during open enrollment each year. As of 2011, open enrollment is from Oct. 15 through Dec. 7.
Medicare Advantage Plans
Medicare Part D also can be part of a Medicare Advantage plan. Medicare Advantage (MA) plans become your primary coverage, but you retain all your rights as a Medicare beneficiary. MA plans also are offered by private companies approved by Medicare, and they also have a monthly premium, copays and deductibles. Rather than having a separate premium for Part D, it's combined into the overall plan.
Other Coverage
You may not need a Medicare Part D plan if you have other medical coverage. This coverage could be through a retirement plan, a spouse, the Veterans Administration or military health care (TRICARE). If you involuntarily lose your health coverage, you can enroll into a Part D plan. If you have no other coverage and you choose not to enroll in a Part D plan, you may be subject to a late-enrollment penalty.
Extra Help
You can apply for extra help with your prescription coverage. Qualifying for extra help is based on your income and your resources. If your means are particularly limited, you may want to apply for Medicaid. Medicaid has no premium, and copays are very low. Medicaid also helps with your other health costs, including doctors visits and hospital care. You can apply for Medicaid through your local Medicaid office.
Tags: Medicare Part, Medicare Advantage, Part Medicare, Part plan, Advantage plan
