Medicare Prescription Plans

Medicare Prescription Plans

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The Best Medicare Prescription Plan for You

If you do not have a Medicare Prescription Plan, you should do it now. If you do not have one when you are eligible, you might have to pay a penalty for late enrollment. A+ Benefits Group works with major health insurance companies to offer you the available options.

With a certification with AHIP, we help you find the best plan suiting your budget and needs at competitive prices, keeping in mind your specific medications, costs, and both short and long term needs. Call us today for a no-obligation insurance review.

Medical Prescription Plan Coverage

Medicare offers prescription drug coverage to everyone with Medicare. Even if you don’t take many prescriptions now, it’s very important for you to consider joining a Medicare drug plan. Just like Part B of Medicare, signing up for Part D (prescriptions) is not mandatory. 

If you decide not to join a Medicare drug plan when you’re first eligible and you don’t have other creditable prescription coverage or don’t get extra help, you will likely pay a late enrollment penalty. 

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 specific drugs covered.

The penalties are not as severe as the Part B late enrollment penalties. The Part D penalty is approximately $3 to $4 added to your premium for each year that you missed. (this # is derived from the average cost of a prescription drug plan in this country multiplied by 1% of the amount of months that you have missed. The average price of a prescription drug plan is approximately $30-$40 a month).

If you join a $0 premium Medicare Advantage Plan that has prescription drug coverage integrated into the plan (as most do), there will still be a penalty assessed to you. But, if you are a veteran and receive your medications through the VA or are covered under an Employer Group plan, you could have what is known as “creditable coverage” and be able to avoid the penalty.

Two Ways to Get Drug Coverage

  • Medicare Prescription Drug Plans. These plans (sometimes called PDPs) add drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private Fee-for-Service (PFFS) Plans, and Medicare Medical Savings Account (MSA) Plans.
  • 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 prescription drug coverage (Part D), through these plans. Medicare Advantage Plans with prescription drug coverage are sometimes called MA-PDs. You must have Part A and Part B to join a Medicare Advantage Plan.
Depending on where you reside, you may have as many as 25 different options to choose from. Each plan will have a different premium, co-pays for covered medication, and different formularies, which are defined as a list of covered prescriptions under each plan.

Making an incorrect choice may have dire consequences. It may cost you a lot of extra money each year, unnecessarily.

Before we get into the steps and resources you should use to select your best Part D drug plan.

When to sign up

Your Part D start date should be the same time that your Part B begins. Do not put this off even if you are not taking any prescriptions currently. If you wait to sign up, you will be penalized for every month you waited. This penalty will stay with you forever, or as long as you have Part D.

The penalty is 1% of the national average for a Part D Prescription drug plan. The national average for a prescription drug plan is approximately $35 per month. You will be penalized 1% or 35 cents per month for every month you missed. 

For example, if you put off signing up for a drug plan for 3 years, you will be penalized 36% or an extra $12.60 per month. This will be added to your prescription drug plan premium, each month. It does not go away.

 Four coverage areas of Part D
  • Deductible 
  • Initial Coverage phase
  • Donut Hole or Coverage Gap
  • Catastrophic Coverage

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Jamie Baumeister was very helpful, very knowledgeable and spend a lot of his certainly precious time in explaining us, coming from Europe and not familiar with the system here, our best options. We chose what he suggested and are very happy with it. It is a good feeling to have such an adviser on your side.

- Johann Christoph Gaedertz

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