Medicare Part D

Medicare Part D

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Medicare Part D

Medicare Part D is a prescription drug plan that can help you with the costs associated with medications. These plans and the benefits provided are offered from a private insurance company. When you enroll, you will be provided with a prescription card to help reduce the costs of generic and brand name medications. Instead of possibly paying the full price for a prescription, you might only pay the copay required by your plan.

There are two ways that you can add prescription coverage to your Medicare coverage. You can either enroll in a stand-alone Part D Prescription plan or you could choose a Medicare Advantage plan that also has Part D included.  

Medicare Part D prescription plans, sometimes referred to as PDPs, will add drug coverage to Original Medicare. You may also be able to add a PDP to some Medicare Private Fee-For-Service (PFFS) plans, some Medicare Cost Plans and Medicare Medical Savings Account (MSA) plans.  Call our family-owned business today for a no-obligation insurance review.
If your filing status and yearly income in 2022 was You pay each month ( in 2024)
File individual tax return File joint tax return
$103,000 or less $206,000 or less your plan premium
above $103,000 up to $129,000 above $206,000 up to $258,000 $12.90 + your plan premium
above $129,000 up to $161,000 above $258,000 up to $322,000 $33.30 + your plan premium
above $161,000 up to $193,000 above $322,000 up to $386,000 $53.80 + your plan premium
above $193,000 and less than $500,000 above $386,000 and less than $750,000 $74.20 + your plan premium
$500,000 or above $750,000 and above $81.00 + your plan premium

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With Medicare Advantage plans, such as HMO or PPO, either the plan will provide some prescription drug coverage or you would need to look at having a separate stand-alone prescription plan. Medicare Advantage plans with prescription drug coverage, are referred to as MAPD plans. A Medicare Advantage plan with out prescription drug coverage would be referred to as a MA plan.  

To enroll in a Medicare Prescription Drug Plan, you must have either Medicare Part A or Medicare Part B. To join a Medicare Advantage Plan, you must have both Medicare Part A and Part B. You also must live in the service area of the Medicare Advantage plan or Medicare Part D plan.  

The initial enrollment period for Medicare Part D is the same as the initial enrollment period for Medicare, beginning 3 months before the month you turn 65 and ending 3 months afterwards. This would be when most individuals would enroll in a Part D or MAPD, unless you have credible coverage from another plan such as an employer plan or the VA. Although you are not required to enroll in a Part D plan, you never know when you might get sick and need to take expensive medications. Not being enrolled in a Part D plan can be risky. Once you’re outside your initial enrollment period, you can enroll or switch plans during the Annual Election Period of October 15th to December 7th with coverage to start on January 1st of the following year”.

Medicare encourages beneficiaries to enroll in a plan when first eligible, by imposing late enrollment penalties. If you don’t have credible coverage and miss your enrollment period, you will begin to accumulate a penalty that continues to grow over time until you enroll in a Part D plan. This penalty will be added on top of your monthly Part D premium. Furthermore, you will have to pay the penalty as long as you are enrolled in a Part D plan.   

If your modified adjusted gross income is above a certain amount, you may pay a Part D income-related monthly adjustment amount (Part D IRMAA). Medicare uses the modified adjusted gross income reported on your IRS tax return from 2 years ago (the most recent tax return information provided to Social Security by the IRS). You'll pay the Part D IRMAA amount in addition to your monthly plan premium, and this extra amount is paid directly to Medicare, not to your plan. Social Security will contact you if you have to pay Part D IRMAA, based on your income. The amount you pay can change each year.   

With Medicare Part D as a stand-alone or within a Medicare Advantage plan, your coverage and benefits can vary. Monthly premiums for Part D plans will differ between each plan option. Each Part D plan has a list of covered medications, called a formulary. These formularies can be different from one plan to another. The costs or co-pays for the covered medications can vary from plan to plan as well. Selecting a plan that doesn’t meet your needs, could result in a lot of extra money spent each year.

A+ Benefits Group is happy to review Part D plans available in your service area. This review includes plans that are stand-alone prescription drug plans (combined with Original Medicare), as well as, those within Medicare Advantage plans. Call us for more information.

I highly recommend Jamie and Joanna for all your health insurance needs. I’ve purchased my health insurance through them for the past few years and was able to continue with their company for my Medicare supplemental insurance when I turned 65.

Each year they shop multiple carriers for me finding the best one to fit my situation, saving me a substantial amount in monthly premiums as well. Their follow-through is excellent, and they are always available to promptly answer any questions I might have.

- Linda Turner

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