What is a Prescription Drug Plan?
While some Medicare Advantage plans provide prescription drug coverage, stand-alone prescription drug plans (PDP) are also offered by private companies. PDPs are often referred to as Medicare Part D. Medicare Part D pays a portion of expenses for drugs as most prescriptions are not covered under Part A or B. PDPs cover drugs that meet all of the following criteria:
- FDA-approved and sold in the USA.
- Available by prescription only.
- Used in an acceptable manner as defined by the SSA.
- Included in the plan’s list of covered drugs or approved through the plan’s exceptions and appeals process.
While Medicare must cover certain basic services, prescription drug coverage is provided by private health insurance companies, and is reviewed on a claim-by-claim basis.
Who is eligible for prescription drug coverage?
- Individuals who are eligible to receive Original Medicare and are enrolled in Medicare Part B can purchase Medicare Part D plans. Note, for the majority of enrollees, you cannot enroll in a PDP if you want to maintain Medicare Part C coverage. The Savers Health team can confirm this for you.
- Plans must accept your enrollment during the open enrollment period (October 15th through December 7th) as long as you permanently reside in the service area of the plan and do not have end stage renal disease.
- You can initially enroll up to 3 months prior to meeting the eligibility requirements for Original Medicare Part B and up to 3 months following your initial eligibility.
How do I enroll in a Medicare Part D plan?
- First, enroll in Medicare Part A and B through your Social Security or Railroad Retirement Board. Enrollment instructions can be found here.
- Consider your prescription drug needs and review the plans that will provide you the best coverage at the most affordable premium. You can do this by visiting MedicareApp and working with your Savers Health team. Savers Health will help determine which Medicare Part D plans work with your financial situation and provide the coverage you need. Your cost of coverage is regulated and is the same regardless of which agent you enroll with, so let Savers help you find the perfect fit as there’s no additional cost to you!
- Select and apply for your Medicare Supplement coverage.
- Once approved, you’ll activate your new plan by paying your first premium and having your new insurance card with you at your prescription fill.
LET'S GET STARTED.
Remember, you’ll likely want to apply for prescription drug coverage as soon as you’re eligible to receive Original Medicare to prevent being charged higher premiums down the road. Savers Health can help you choose a plan and apply for coverage at no additional cost. Please fill out the form below and we will get back to you as soon as possible with a quote.
You can also review plans on your own and apply for the one that meets your needs…try the MedicareApp Platform!
If you start and get stuck…call us and we can help you finish!