FRIDAY, NOVEMBER 20, 2020
Understanding Medicare Prescription Drug Plans
When you qualify for Medicare, you will want to make sure you have appropriate coverage for all your health care needs, no matter how numerous. One of the most commonly needed benefit is prescription drug coverage that can help you afford essential medications. It might surprise you to learn that if you only buy the most standard Medicare option available, then prescription drug insurance will likely not be available. To get this benefit, you will have to buy an additional plan.
There are generally two ways to get prescription drug coverage for your Medicare benefits: Medicare Advantage (Part C coverage) or a Medicare prescription drug plan (Part D coverage). Let’s take a closer look at these benefits.
Understanding Medicare and Prescription Benefits
When you become eligible for Medicare, you qualify for the U.S. government’s Original Medicare plan. It will contain two types of medical benefits: Part A which covers hospital costs, and Part B which covers more routine medical care, such as physicals. One thing that neither plan will cover, however, is the standard prescription drugs that millions of Americans take.
To get prescription drug benefits, you can either choose a Medicare Advantage plan or a Part D prescription drug plan. These are both private plans offered by numerous major insurance companies.
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Medicare Advantage plans are essentially an enhanced version of Original Medicare. They offer the benefits of both Part A and Part B coverage, but also expanded benefits like dental, vision and of course, prescription drug coverage.
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Some people do not qualify for a Medicare Advantage plan. However, a Medicare Part D plan is another option that you can buy alongside your Original Medicare to add the requisite prescription drug benefits.
Because there are multiple Medicare Advantage and Part D coverage options on the market, you can work with your agent to determine which one is best for you. Both plan options must meet standards set by federal law. However, they can charge their own premiums (which you will have to pay alongside your Original Medicare premium) and will include their own formularies that dictate which drugs they will cover for the patient. Drugs will usually cost the patient a co-payment.
However, your independent insurance agent is happy to work with you to determine the prescription drug plan that is best for you. Because plans can vary, it does help to have an expert on hand to help you choose the right one. Generally, the best time to get this coverage is when you first become eligible for Medicare itself. While there are sometimes opportunities to enroll in or change your benefits later, it is always best to start your Medicare experience with either a Part C or Part D benefit.
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