Medicare Part D is a prescription drug plan offered by the government for people who have Medicare. Sounds simple enough, right? Wrong! It can be more confusing than rocket science. Don't worry, though - we're here to simplify it for you.
There are four phases: the deductible phase, the initial coverage phase, the coverage gap, and the catastrophic coverage phase. If you think these sound like the stages of grief, you're not far off. But don't worry, we'll explain each one.
Now, let's talk about the penalties. If you don't enroll in Medicare Part D when you're first eligible, you may have to pay a penalty. Think of it like being late to a party, except instead of bringing a gift, you have to pay money. The penalty is based on how long you you went without prescription drug coverage and is permanent. Now, you might be thinking, "Well, what if I just never enroll in Part D? Then I won't have to pay any penalties." Nice try, but it's not that simple. If you go without creditable prescription drug coverage (meaning coverage that's at least as good as Part D) for 63 days or more after your initial enrollment period, you may have to pay a late enrollment penalty when you do finally enroll in Part D. And yes, this penalty is also permanent.
If you are enrolled in Original Medicare ,then you have to purchase a separate Part D plan. If you are enrolled in a Medicare Advantage plan, your Medicare Part D is usually included. Check your plan.
In summary, Medicare Part D is more confusing than trying to teach a cat to swim. But if you enroll on time and understand the phases, you'll be one step closer to understanding this complex program.
There are four phases: the deductible phase, the initial coverage phase, the coverage gap, and the catastrophic coverage phase. If you think these sound like the stages of grief, you're not far off. But don't worry, we'll explain each one.
- The deductible phase- It's the phase where you have to pay your Part D deductible before your plan starts covering your prescription drugs. You pay the full cost of your drugs until you reach your deductible. Once you've paid your deductible, you move on to the next phase.
- The initial coverage phase- You'll pay a co-pay or co-insurance for each drug that you get, and your Medicare Part D plan will pay the rest until you reach a certain limit ($4660 for 2023).
- Once you reach that limit, you enter the coverage gap also known as the donut hole. you'll pay a larger percentage (usually no more than 25%) of the cost until you reach the amount of $7400.
- Catastrophic Phase: After reaching the $7400 limit, you enter the this phase where you only pay a small copay or coinsurance for your prescription drugs.
Now, let's talk about the penalties. If you don't enroll in Medicare Part D when you're first eligible, you may have to pay a penalty. Think of it like being late to a party, except instead of bringing a gift, you have to pay money. The penalty is based on how long you you went without prescription drug coverage and is permanent. Now, you might be thinking, "Well, what if I just never enroll in Part D? Then I won't have to pay any penalties." Nice try, but it's not that simple. If you go without creditable prescription drug coverage (meaning coverage that's at least as good as Part D) for 63 days or more after your initial enrollment period, you may have to pay a late enrollment penalty when you do finally enroll in Part D. And yes, this penalty is also permanent.
If you are enrolled in Original Medicare ,then you have to purchase a separate Part D plan. If you are enrolled in a Medicare Advantage plan, your Medicare Part D is usually included. Check your plan.
In summary, Medicare Part D is more confusing than trying to teach a cat to swim. But if you enroll on time and understand the phases, you'll be one step closer to understanding this complex program.
|
Before you complete the contact form please read the following disclaimer:
According to Medicare rules, we need your permission to contact you to discuss your Medicare plan options. The person who will be discussing plan options with you is with or contracted by a Medicare health plan or prescription drug plan that is NOT the Federal Government, and they may be compensated based on your enrollment in a plan. Discussing Medicare plans options does NOT affect your current enrollment, nor will it enroll you in a Medicare Advantage Plan, Prescription Drug Plan, or other Medicare plan. |
|
(We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options regarding Medicare, Medicare Advantage and Medicare Supplement plans and Prescription Drug plans.)
