How Does Medicare Part D Work?

Medicare Part D is coverage that can help you pay for prescription drugs if needed, and drug coverage can be beneficial even if you don’t currently require any medications. Late enrollment is an option due to a late fee requirement. There are two ways you can typically get coverage that will be covered here. Our agents at E-Shop Medicare are specialized in helping you sort through your Medicare options so you can have the best coverage suited for you, including drug coverage such as Part D.

How Do I Get Prescription Drug Coverage?
There are two common ways to get Medicare Part D Coverage:
medicare stamp with medications around it

medicare stamp with medications around it

1. Medicare drug plans—You must first have Original Medicare (Medicare Part A and/or Medicare Part B) to join a different Medicare drug plan. This option can add coverage to plans such as Original Medicare, some Medicare cost plans, some Private Fee-for-Service plans and Medical Savings Account plans.

2. Medicare Advantage Plan (Part C)—You can get all of your Part A, Part B and drug coverage through this plan. You must have Part A and Part B coverage to have drug coverage. Not all Part C plans have drug coverage.

Once you choose one of the above plans best suited for your needs, you can start your enrollment process for drug coverage. The following are steps you should follow:

Enroll on the Medicare Plan Finder or the plan’s website.
Complete a paper enrollment form.
Call your plan.
Call 1-800-MEDICARE (1-800-633-4227).

How Does Medicare Part D Work with Other Forms of Insurance?
If you have other forms of insurance and are wondering how drug coverage could come into play for you, determine what your next steps are by learning how drug coverage works with current plans such as:

Union health coverage—If you have drug coverage based on your current or previous employment, your employer or union will notify you each year to let you know if your drug coverage is creditable. Keep the information you get. Call your benefits administrator for more information before making any changes to your coverage.
The Consolidated Omnibus Budget Reconciliation Act (COBRA)—If you take COBRA and include creditable prescription drug coverage, you’ll have a particular enrollment period to join a Medicare drug plan without a penalty when COBRA ends. You may want to have drug coverage in addition to COBRA. There is often a special enrollment period to join without a penalty.
Medigap—Medigap policies can no longer be sold with prescription drug coverage, but if you have drug coverage under a current Medigap policy, you can keep it. If you join a Medicare drug plan, your Medigap insurance company must remove the prescription drug coverage under your Medigap policy and adjust your premiums.
Medicaid—Medicare covers your drug costs. You’ll need to join a Medicare drug plan for Medicare to pay for your drugs.
Supplemental Security Income (SSI) benefits—If you get benefits or help from your state Medicaid program paying your Medicare premiums, you need to join a Medicare drug plan for Medicare to cover your drugs.
State Pharmaceutical Assistance Program (SPAP)—How prescription drug coverage works will vary by state. Contact you SPAP for more information.
Long-term care facility—Long-term care pharmacies contract with Medicare drug plans to provide drug coverage to their residents. If you’re entering, living in, or leaving a nursing home, you’ll have the opportunity to choose or switch your Medicare drug plan. This allows you to select a plan that contracts with your nursing home’s pharmacy.
The U.S. Dept. of Housing and Urban Development (HUD) Housing Assistance—If you qualify for Extra Help (a Medicare program to help people with limited income and resources pay Medicare prescription drug program costs, like premiums, deductibles, and coinsurance), you won’t lose your housing assistance. However, your housing assistance may be reduced as your prescription drug spending decreases. The value of the Extra Help paying your drug costs will make up for any decrease in your housing assistance.
Food stamps—If you get food stamps, you may want to join a Medicare drug plan. Your food stamp benefits may decline if you qualify for Extra Help, but Extra Help will offset that decline.

If you don’t see your coverage listed and are wondering how it may be impacted or how to get drug coverage, contact an agent today for more information.

Get Started with Coverage Today
At E-Shop Medicare, we know how crucial it is to be on top of your Medicare enrollment and coverage. Connect with the agent today if you’re looking to get started with Part D coverage or have additional questions.

How Does Medicare Part D Work?

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