Medicare Part D

The Basics of Medicare Part D

Anyone who has ever had to buy name-brand prescription drugs or generic drugs knows how quickly the costs can add up. For most, routinely paying hundreds of dollars each month for medicine isn’t feasible. As a result, some have to go without it. To help cover some of the burdens of these costs, Medicare introduced Part D into the plan. In essence, Medicare Part D will provide coverage for specific prescription medication and drugs, lowering the cost for the end-user. Similar to Medicare Part C, you will need to go through a private insurance company to enroll. Monthly premiums and out-of-pocket expenses are still required; however, the cost is only a fraction of what you would pay without it.

The annual deductible for Medicare Part D is an important number to keep in mind when thinking about costs. For example, in 2023, if you were to reach the Initial Coverage limit ($4660) in total drug costs for the year, you would only be required to pay 25 percent of the costs for the remainder of the year. If you find that your expenses hit the $7,400 limit, then you are only responsible for 5 percent of costs that year.

What Coverages Are Available Under Medicare Part D?

One of the biggest misconceptions of Medicare Part D is when the coverage starts and which medications are paid for. For example, if you receive a prescription drug or medication while in a medical facility, it would fall under the coverage plan for Medicare Part B. Where Part D takes effect is when the prescription is considered outpatient as opposed to inpatient. Other areas that you might not receive assistance with include over-the-counter medications, hair growth drugs, weight loss supplements, or vitamins. For the medications that qualify under Medicare Part D, you will have the option of buying the generic version or a slightly higher cost-sharing charge, the name brand.

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The Expense of Medicare Part D

Since plans for Medicare Part D go through a private insurance company, there tends to be flexibility in the overall coverage cost. A study done by The Centers for Medicare and Medicaid Services found that, on average, a beneficiary can expect to pay a monthly premium of around $31.50 for 2023. This can vary by plan.

Not every Part D plan has a deductible, and each Part D carrier can set the deductible for their plans. However, no plan can go above the maximum Part D deductible of $505 in 2023.

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Understanding all the parts of Medicare is only the first step in the process. The challenge becomes making sure you select the right plans and coverages to keep you protected no matter the scenario. To schedule a time to talk, call (440) 230-1223 OR (239) 920-5220.