Medicare offers prescription drug coverage to everyone with Medicare. Prescription drugs can be a major cost as you age and they are NOT covered by Original Medicare. There are two ways to get Medicare prescription drug coverage:

1.  Medicare Prescription Drug Plans (sometimes called “PDPs”). They can be added to Original Medicare and Medicare Supplement (Medigap) Plans.

2.  Part D coverage may also be included in a Medicare Advantage  plan (sometimes called MA-PDs).

When purchasing a stand-alone Part D insurance plan to go along with a Medicare Supplement (Medigap) plan, it provides protection against catastrophic health care costs.

Part D plans are offered through private insurance companies. Plans vary widely, as do prices. How specific drugs are covered also differs among plans, too. Even if you do not take a lot of prescriptions now, you should still consider joining a Medicare drug plan. To get Medicare prescription drug coverage, you must join a plan run by an insurance company or other private company approved by Medicare. Each plan can vary in cost and drugs covered.

If you decide NOT to join a Medicare drug plan when you are first eligible, and you do not have other creditable prescription drug coverage, you will likely pay a late enrollment penalty. See BELOW: Employer Coverage.

There are two ways to get Medicare prescription drug coverage:

1. Medicare Prescription Drug Plans. These plans (sometimes called “PDPs”) add drug coverage to Original Medicare and an option to add a Medicare Supplement (Medicare Gap) plan.

2. Medicare Advantage Plans (like an HMO or PPO) or other Medicare health plans that offer Medicare prescription drug coverage. You get all of your Part A and Part B coverage, and rescription drug coverage (Part D), through these plans. Medicare Advantage Plans with prescription drug coverage are sometimes called “MA-PDs.”

Who Can Get Medicare Drug Coverage?

To join a Medicare Prescription Drug Plan, you must have Medicare

Part A OR Part B. To join a Medicare Advantage Plan, you must have Part A and Part B. You must also live in the service area of the Medicare drug plan you want to join.

OPTIONAL:  Employer or Union Health Coverage—Health coverage from your, your spouse’s, or other family member’s current or former employer or union. If you have prescription drug coverage based on your current or previous employment, your employer or union will notify you each year to let you know if your prescription drug coverage is CREDITABLE.
(This means that your employer prescription coverage is equal to or better than the national medicare Part D coverage.) Keep the information you get each year as you will have to produce a copy of this letter if you decide to change from your employer coverage. Call your benefits administrator for more information before making any changes to your coverage.

Note: If you join a Medicare drug plan you, your spouse, or your dependants may lose your employer or union health coverage. You also may not be able to drop your employer or union drug coverage without also dropping your employer or union health (doctor and hospital) coverage. If you drop your employer or union coverage, you may not be able to get it back.

WE can help you make sure make the RIGHT decision and you have the RIGHT plan for your health and financial needs. Call our office and ask for the Medicare specialists for health and prescription drugs.


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