If you have been told about Medicare, you know that Medicare insures some of your health care and names them alphabetically. Medicare Part A is health insurance. Medicare Part B is medical insurance.
Medicare Part D is also known as prescription drug plan. Medicare Part C (a.k.a. Medicare Advantage) is one way to get Medicare Part A, B and D benefits in a single policy. The prescription of Medicare Part D for prescription drugs is generally included in Medicare Advantage policies. According to Kaiser Family Trust, about 88% of Medicare Advantage policies in 2017 offered coverage for prescription drugs.
What is Medicare Advantage?
It is a Medicare insurance offered by private insurance companies that subscribe to Medicare. Medicare Advantage policies must insure everything that Original Medicare insures (Part A and B). In addition to the supply of prescription drugs, Medicare Advantage policies often offer additional benefits, such as:
What is Medicare Part D?
Part D of Medicare is coverage for prescription drug. You can buy Medicare Part D through a single policy or through a Medicare Advantage policy. If your Medicare advantage policy includes prescription drug insurance, you will not be eligible for a separate Medicare Part D prescription drug policy at the same time. The independent prescription drug policies for Part D are usually combined with the original Medicare insurance.
All Medicare Part D insurance is provided by private insurance companies instead of the federal government. The government’s Medicare program, Original Medicare, does not insure most of the prescription drugs you take at home. Generally, you only receive the original benefits of Medicare prescription drugs if you get them as an inpatient or as an injection in a doctor’s office. There may only be other situations in which Original Medicare pays for prescription drugs. Without Medicare Part D, you may have to pay most of your prescription drugs out of your pocket.
How does a Medicare Advantage policy with Medicare Part D insure my prescription drugs?
Prescription drugs insured by your Medicare Advantage policy are listed in the policy formula or on the list of insured drugs. If a prescription drug you need is not included in your Medicare Advantage policy’s prescription form, you can seek insurance or change policies during the open enrollment period, October 15th through December 7th of each year. Medicare Advantage policies generally set the insured drugs at levels that can be used to charge for a variety of prescription drugs. Level 2 prescription drugs generally cost more than level 1 prescriptions and so on.
For example, for a 30-day delivery of your medication, you could pay:
- Level 1 (Preferred Generic) $ 10.00 co pay
- Level 2 (generic): $ 17.50 co pay
- Level 3 (preferred brand): $ 45.00 co pay
- Tier 4 (Non-preferred drug): $ 95.00 co pay
- Tier 5 (Specialty Tier) 33% co insurance
- Level 6 (selective care drugs) $ 10.00 co pay
Do you want to find a Medicare Advantage policy near you that treats Medicare Part D for prescription drugs? Simply enter your zip code on a Medicare website to start the search.