Getting drug coverage with Medicare

As a Medicare user you probably know that Original Medicare Part A and Part B do not cover drug prescriptions and that you will have to pay for the medication your doctor prescribes you. If you would like to save some money, there are two ways in which you can get drug coverage with Medicare through some plans that Medicare offers. In this article you will find information about these and how to enroll on them.

     How to can I drug coverage with Medicare?

There are two ways in which you can get drug coverage with Medicare. The first one is through a Medicare Prescription Drug Plan (Part D), which adds drug coverage Original Medicare, some Medicare Cost Plans, some Medicare Private Fee-for-Service Plans, and Medicare Medical Savings Account Plans. You can get one of these through a private insurance company.

The second way in which you can get drug coverage with Medicare is through a Medicare Advantage Plan, like a Health Maintenance Organization plan.  With a Medicare Advantage Plan you get Medicare Part A (Hospital Insurance), Medicare Part B (Medical Insurance) and prescription drug coverage. These types of plans are also known as “MA-PDs” because they include the drug coverage. This plans are also gotten through a private insurance company.

     What do these plans cover?

Depending on the plan you get, the coverage will vary. However, each plan has a formulary, which is a list of covered drugs and they are placed in “tiers”, so each tier has a different cost. Medicare drug plans can make changes in their formularies, but they must inform you through a written notice at least 60 days before the changes become effective if you are taking a drug that is involved in them. Additionally, Medicare drug plans must cover all commercially available vaccines.

When and how can I enroll on a Plan with drug coverage?

You can enroll on one of these plans or make changes on the plan you already have on specific times.

The first moment in which you can get one is during the Initial Enrollment Periods for Part C & Part D, when you first get Medicare. In this case, there a few situations that influence the moment when you can get the plan.

If you are new eligibly because you just turned 65, you have a disability and you are under 65 or you have both a disability and just turned 65, you can enroll on a plan with drug coverage 3 months before you turn 65, during the month you turn 65 or 3 months after you turn 65. In case you are under 65, the month in which the person turns 65 will be replaced with your 25th month of getting disability benefits.

If you have Medicare Part A coverage and you enrolled in Mutual of Omaha Medicare Supplement during the Part B General Enrollment Period (January 1–March 31), you can sign up for a Medicare Advantage Plan between April 1 and June 30. If you do not have Medicare Part A coverage and you enrolled in Medicare Part B as previously mentioned, you can sing up for a Medicare Prescription Drug Plan between April 1 and June 30.

The second moment in which you can get a plan with drug coverage is during the Open Enrollment Period for Medicare Advantage and Medicare prescription drug coverage. The third moment in which you can get a plan with drug coverage is during the Medicare Advantage Disenrollment Period. If you do it during the MA disenrollment period, you will have to switch to Original Medicare and join a Medicare Prescription Drug Plan.


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