What is Medicare Part D?
Medicare prescription drug coverage (Part D) is a lot like other insurance you have used throughout your life. Medicare Part D covers prescription drug costs only. A private health insurance company manages it for a monthly premium. Part D is open to everyone on Medicare, regardless of income. Part D plans generally include low co-payments or co-insurance for both brand name and generic prescription drugs. Whether you are seeking coverage, or have it with another plan, the right Medicare Part D plan can save you money.You can choose Part D coverage as a stand-alone prescription drug plan. You can also get Part D as part of Medicare Advantage Plans,which offer benefits beyond prescription drugs for a higher premium. You always have lots of options.Just choose the plan that works hardest for you.
Five simple questions you need to ask:
1.Does my plan live up to Medicare standards?
2.What are my up-front costs?
3.Will the plan cover the drugs I need today AND tomorrow?
4.Is this the simplest plan, or are extra steps needed to get my drugs?
5.How much do I pay for each drug?
The choices you make now can make a big difference in 2010.
Open Enrollment ended December 31, 2009.
With few exceptions (see below), your next opportunity to enroll will be from November 15, 2010 to December 31, 2010. Will you be ready?
You can apply after December 31, 2009 without penalty if you meet ANY of these criteria:
1.You turn 65 after the December 31, 2009 plan submission deadline.
2.You qualify for Medicare’s Low Income Subsidy Assistance.
3.You move out of your plan’s service area.
4.You and your spouse are both enrolled in Medicare and Medicaid.
5.You live in, or move into or out of an institution (like a nursing home).
6.You have creditable prescription drug coverage and that coverage ends.
What will I pay with Medicare Part D? How much coverage will I get?
1. You pay a monthly premium,which varies from plan to plan, depending upon the details of coverage. In 2010 the monthly premiums in Maine vary from $14.70 to $87.20.
2. Depending on your plan you pay an annual deductible of $0 to $310
.3. The plan will then cover prescription expenses with co-pay,up to $2,830.Co-pays vary by plan.
4. At this point coverage stops and you pay all prescription costs until your total prescription expenses reach $4550.You maybe able to choose a Part D insurance plan to handle some or all of these “out of pocket” costs, or buy additional coverage on
your own. It’s often called “gap insurance” and it’s available from a wide range of providers. Excellent information is available from the Eastern Area on Aging.
5. After your expenses go over $4450, your Medicare drug plan pays almost all of your covered costs.You pay a small copayment, no matter how high your drug costs go in 2010.
6. Find out if you are eligible for extra help paying for a plan. If your 2009 income was less than $16245 (single)or $21855 (married and living with your spouse) and your combined savings, investments, and real estate (other than your home) are not worth more than $12510 (single), or $25010 (married and living with your spouse), you may be eligible for extra help. For more details call 1-800-MEDICARE (800-633-4227).
I already have a Medicare Part D plan. Why change now?
Every eligible Part D plan an insurance company offers you must meet a minimum standard outlined by Medicare. But why just settle for just good enough, when your 2009 plan may not be the best answer? Formularies, premiums, deductible and more can change from one year to the next. So a new plan may be better for your needs. It’s time to go shopping. That’s what Open Enrollment is really all about. You’re shopping for insurance. And it can pay to shop around. Who wouldn’t want to get more prescriptions filled for less money in 2010?
The staff at Eastern Area on Aging (800-432-7812) can help. They’re trained in Medicare Part D details. They’ll take the time to answer your questions so you can choose the best plan. That gives you peace of mind that can only help you feel better in every way in 2010.Why spend the next year wondering if you could have spent less? Consult the trained staff at the Eastern Area on Aging to help find the best plan for you. Before you contact them, have the following information available:
The above was adapted and updated from from Rite Aid "Medicare 2009, Prescription Drug Plan Guide