What is Medicare Part D?
Medicare Part D is Medicare’s prescription drug benefit that provides outpatient drug coverage. Part D is provided through private insurance companies contracted with the federal government.
If you want Part D coverage, you have to either buy a standalone plan or get it through a Medicare Advantage plan.
What Drugs are Covered?
Prescription Drug Plans and Medicare Advantage Prescription Drug Plans cover all vaccine drugs when necessary to prevent illness. Other than that, you will have a formulary unique to your plan that details what drugs are covered. So, before you choose a plan, you need to talk to a licensed Medicare specialist like the ones at Acadiana Insurance Advisors to make sure all the drugs you require are covered with your plan.
What are the Different Plans?
Depending on your plan, this answer will differ. However, these are some drugs that will most likely not be covered under any prescription drug plan:
Weight loss or weight gain drugs
Any drugs for hair growth
Fertility drugs
Drugs for erectile dysfunction
Any over-the-counter drugs
You are Notified of Any Changes
You can rest assured that all Medicare Prescription Drug Plans are required to publish any changes to its formulary on the plan’s website. The insurance company must also tell you when drugs are removed from the Part D formulary.
All plans are restricted from making changes to the drugs provided and making price changes between the beginning of the annual election period until 60 days after coverage begins. The only exception is if the FDA determines a drug is unsafe or the manufacturer ceases production of the drug.
Also, any changes must include the name of the drugs removed, if the drug changes tiers, the reason for the change, alternate drugs available, any cost sharing, and exceptions available.
Medicare Advantage Costs
Once you purchase a prescription drug plan, you have the right to:
• Receive a written explanation from your plan about your benefits
• Ask for exceptions if a drug you need is not covered by your plan
• Ask for exceptions to waive coverage rules
• Ask for lower copayments for higher-cost drugs if you or your prescriber believe you can’t take lower-cost drugs for your condition
Don't Risk Getting the Wrong Coverage
Work with the Best!
We understand the Medicare enrollment process can be difficult to understand. This is why we strive to educate and empower our clients to make the best decisions for their health insurance coverage.
Don't Make These Mistakes When You Enroll
Medicare can be a nightmare to understand. This book helps you avoid some common pitfalls when it comes to enrolling.
We are not connected with or endorsed by the United States government or the federal Medicare program. We do not offer every plan available in your area, and any information we provide is limited to those plans we do offer in your area. Please get in touch with Medicare.gov or 1-800-MEDICARE to get information on all your options. Health Insurance sold on
frommeinsuranceservices.com is processed through the licensed entity: Garden State Medicare Solutions.