| Thu, Oct 28, 2010 @ 09:00 AM

Medicare Part D 101

Posted by Medicare Made Clear

Medicare Part DMedicare Part D provides help with the cost of prescription drugs for Medicare beneficiaries and is offered by private insurance companies. You can purchase a Prescription Drug Plan (PDP) separately or select a Medicare Advantage Plan that includes drug coverage.


Because they are offered by private insurance companies,Medicare Advantage Plans Medicare Part D plans can vary widely in price and coverage. Some plans will specify the pharmacies in which you can fill your prescriptions while others will only cover you in certain areas. If you travel regularly you may want to look into a plan that does not limit the geographic areas in which you can fill your prescriptions. The federal government has set guidelines to ensure that certain drugs are covered under all Medicare Part D plans. It is important to ensure that the plan you choose covers the prescriptions you use.

Part D coverage has different levels of cost sharing until you have spent your out-of-pocket maximum. In 2011, if you have spent your out-of-pocket maximum, you will no longer be responsible for paying 100% of the drugs you purchase. Instead you will pay 93% of the cost of generic drugs and about 50% of the cost for most brand name drugs. Your plan will take care of the rest for the remainder of the year.


All Medicare recipients are eligible for Medicare Part D. If you are entitled to Medicare Part A or are enrolled in Medicare Part B, you cannot be turned down for a Medicare Part D plan during your initial enrollment period. During this time you can either enroll in a Medicare Advantage plan that includes prescription coverage, or a Medicare Part D plan.


The cost of Part D drug plans and Medicare Advantage plans can vary even for plans with similar coverage. This is why it is important to research the plans available to you and their costs. It is best to sign up for a Part D plan as soon as you become eligible because you may be charged a penalty or face higher premiums if you delay. Each year your insurance provider will announce any changes to premiums and coverage in October. You will then have the option to switch your Medicare plans during the Annual Election Period (AEP).


When you age into Medicare at 65, you’ll have an opportunity to enroll in a prescription drug plan. You may enroll during the next AEP if you do not enroll during your Initial Enrollment Period. The 2010 AEP begins November 15 and ends December 31. Few exceptions allow enrollments outside of an enrollment period, such as moving to another coverage area. If you believe you may be eligible for an exception, contact your local Social Security office.

Additional Resources




The family of UnitedHealthcare® Medicare Solutions plans are insured or covered by an affiliate of UnitedHealthcare, a Medicare Advantage organization with a Medicare contract and Medicare-approved Part D Sponsor.

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