If you are at least 65 years old or on disability such as SSDI, you quality for Medicare. There are different parts to Medicare (you need to be aware of them all), which are often confusing to most recipients (mostly) since it’s a lot of information to absorb plus insurers want to make it difficult. Part B of Medicare is for your medical care and hospitalization and then Medicare Part D has a formulary for your prescription drug plan.
Original Medicare an Automatic Enrollment
When Medicare goes into effect you are automatically enrolled in the Original Medicare along with the prescription plan (you get to choose when to enroll). Original Medicare was all that used to be available to beneficiaries but today you do have other options and which one you choose is entirely up to you. Doctor visits and other such services are a standard 80/20 split. Prescription drug costs range anywhere from $2 to $7 depending on generic vs. non-generic, once you reach the doughnut hole it’s going to cost a whole lot more.
Prescription Drug Plan
There is a stand alone Prescription Drug Plan (also called PDP) that can be enrolled into at the time of eligibility, you’ve got this tool for doing some research. This typically means you have one Medicare card for your doctor’s appointments and another for your prescriptions. Prices vary but typically generic are $1 to $3 while brand names may be as much as $6.50.
Medicare Advantage Plan
This has been a very popular plan as of late because it acts more like an HMO similar to what many employees have with their employers. Several insurance plans offer this such as Cigna, Blue Cross Blue Shield and many others. Medicare has used the Advantage Plan as a better option than ‘Medigap’ which used to ‘fill in the gap’ of those that had to pay out of pocket expenses a good portion of the year.
The Medicare Part D formularies on all prescription drug plans tend to vary. For instance, some drugs will only be available via mail order, while others may be approved on one plan and denied on another. The best way to choose the Part D that is right for you is to get a list of all your medications you currently take and call the provider to see if the medications you take are covered under the plan. Obviously, if some of your medications are not covered, you will probably want to stick with the Original Medicare.