Of all the Medicare plans, the Part D Prescription (PDP) plans are the most confusing. The confusion arises because Medicare allows the Part D plans to offer alternate plans that differ from the standard plan. The alternate plans must be as good as the standard plan for the average Medicare beneficiary. Cost Sharing of the […]
Part D Prescription Plans
Posts on Medicare Part D Prescription Drug plans included in Medicare Advantage or stand alone PDP with Original Medicare and Supplement.
Medicare Prescription Drug Extra Help for 2023
There are 2 levels of extra help, full and partial. With full extra help, there is no plan premium, plan deductible (if the Part D plan has one), and prescription drug costs are capped at $4.15 for a 30 day supply of generics and $10.35 for brand-name drugs.
Medicare Part D Prescription Drug Comparison Confusion
In California there are 32 different Part D plans offered by 11 different insurance companies. One plan sponsor offers six different plans. The only thing that differentiates these plans at first glance are the marketing names like Basic, Choice, Classic, Enhanced, Plus, Saver, Secure, and Value. These monikers are marketing gimmicks and tell the Medicare beneficiary nothing about the benefits of the plan.
Figuring out the New Coverage Gap of Part D Prescription Drug Plans
All of the out-of-pocket drug cost the consumer pays goes toward pushing them through the coverage gap and potentially into the catastrophic phase. These costs would include any deductible, copayments and coinsurance of the initial coverage phase, and the 25 percent coinsurance in the coverage gap. However, in the coverage gap, the consumer’s accumulated dollar amount is credited with the drug manufacturers 70 percent discount on brand name drugs.
Building Your Medicare Train Of Health and Drug Coverage
The great thing about Medicare is that you can build your train the way you want. You can change the train cars every year. But the important aspect is that you own the Medicare engine. You are the engineer and you can build your train the way you want it.
Maintaining Health Insurance Coverage After California Wildfires
If you have to move out of your county because of the wildfires you may be entitled to a Special Enrollment Period. California is broken into 19 different rating regions. Los Angeles County is actually two regions, 15 and 16. If you move to a different region, you have a qualifying event for a Special Enrollment Period IF you already have health insurance.
Navigating The Medicare Maze Of Options
This high level overview and will not address every situation that a Medicare beneficiary may find them self in. This short primer is meant help you understand the different parts of Medicare and how they work, or don’t work, together. The following information can also be found in the Medicare and You Handbook.
Making sense of Medicare’s Prescription Drug Plan with training
2015 CMS PDP Training Prescription drug coverage for Medicare beneficiaries can be confusing. Under different health care scenarios some drugs may be covered by Part A, Part B or Part D of Medicare. In addition, many Medicare beneficiaries may be unaware that they might qualify for extra help to pay for their medications. The Centers […]
Medicare more expensive than new ACA plans
Individuals who recently acquired Parts A and Part B of Original Medicare may find they have to pay more per month than their existing ACA health plans. Under the ACA rules, once someone accepts Medicare, they must exit any ACA health plan they purchased through the exchange and the tax credits that make it affordable. […]
Medicare Prescription Drug Plan finder function is great
Before you talk to any insurance agent, prescription drug plan call center or sign up for a Part D Prescription (PDP) drug plan from a direct mail advertisement go to Medicare.gov and do a plan comparison. The Medicare prescription drug insurance plans are the most complicated and confusing of all the Medicare decisions a beneficiary must make. The Centers for Medicare and Medicaid Services has built one of the best online comparison tools for evaluating PDPs.