How To Apply for the Medicare Part D Plan

Doctor with elderly couple

Medicare coverage is a notoriously confusing system, even to the health care provider. Unfortunately, the confusion surrounding Medicare Part D Plan is even worse. Many are dismayed and confused by the seeming lack of effort from our government officials to clarify and explain enrollment procedure. I'd like to help make it a bit clearer for you.

Basically, Medicare Part D is the new prescription drug coverage program that offers discounted prices for most prescriptions, both generic and name brand. This program was created to offset the rising cost of medication for seniors on a fixed income. Anyone who is currently enrolled in Medicare Part A or B is eligible to additionally enroll in Medicare Part D insurance.

In a few steps, you can add Part D to your own existing Medicare coverage. It can also be accessed through a Medicare HMO or PPO. Of course, there may be an additional monthly charge for this prescription coverage, to be decided through the modified gross income that is listed on your tax filing. This fee ranges from $15 to $70 per month.

To help make sense of it all, here are some important tips you should know about Medicare and, more specifically, how to enroll in Medicare Part D insurance:

  • Determine your eligibility. In order to be eligible for Medicare Part D, one must first have Medicare Part A or Part B. Medicare Part A is the hospital insurance that typically pays for inpatient care and, if needed, a skilled nursing facility (if you were recently in the hospital). Medicare Part B is the insurance that covers you when you see your physician or health care provider. And as you know, you must be a citizen of the United States as well as age 65 or older to qualify for Medicare. For both of the aforementioned programs, there are premiums as well as deductibles. These vary based upon whether or not you have other health insurance coverage, and can also vary over time.
  • Start the process. Navigate to the website created for Medicare Part D enrollment that is located here. Choose the option to “Find and Compare Plans” once there. This site will direct you to as much Medicare information as you will need.
  • Consider all the costs associated with each plan. There will be an additional monthly charge for Medicare Part D coverage. This is due to the fact that the plan comes with a monthly charge, deductibles, and co-pays.
  • Avoid the gap. There are some Medicare Part D programs that have a gap in coverage. This means that the cost of all prescriptions is covered until the participant reaches a certain amount in annual expenditures. From that point the customer will have to pay for all medications out of pocket until another amount has been met. 

    As an example of the prescription coverage gap, some companies will cover all costs for prescriptions until the total reaches $2000 in one year. At that point the participant will need to pay for all their own medications until the total amount reaches $4000 in the same year. At that point the medications will once again be completely covered by the insurance. This process will start over the next year.

  • Pick a plan. Once you have found the right plan you can enroll online. You can do so 3 months after enrolling in Medicare for the first time. For all other Medicare members there is an annual deadline, during which you will be able to enroll within the enrollment period beginning November 15 and ending December 31 of every year.

My advice is, get in direct touch with a government Medicare center. There are no secrets about this program: as long as you have both Medicare Part A and Medicare Part B, you can enroll in Medicare Part D. You don't have to call one of the many companies offering coverage. Just get in touch with The Centers for Medicare and Medicaid Services (CMS) for the clearest information.

If you do choose to call one of the many companies offering Medicare Prescription coverage (Medicare Part D), you will be talking with a representative of that company. It's a jungle out there and these people will not help you cut through the thicket to see what's best for you. That's why I recommend that before you call one of the many companies that are using clever sales methods, contact your Medicare office first. You could save time and money!

The representatives of the Medicare administration are trained to discuss Medicare benefits and help you decide which plan is best for you, given all the options offered to you as well as your needs. The personnel at Medicare will assist you in comparing the prices of the many companies, provide information about them with respect to their hidden fees, and generally look out for your best interest. To save money and prevent potential heartache, it may be best to contact Medicare directly as opposed to choosing one of the several companies that are marketing their own plans on television and other media.


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