Part D Prescription Drug Plans
Let us help you with enrollment.
If you are already enrolled in a Part D “standalone” Prescription Drug plan or a Medicare Advantage plan that incorporates drug coverage, you can switch plans during the open-enrollment period, which runs from Oct. 15 to Dec. 7 every year. Otherwise, you can sign up for Part D Prescription Drug Plans starting three months before your 65th birthday.
Making Part D work
Most Prescription Drug Plans have a coverage gap called a donut hole. This means there’s a temporary limit on what the drug plan will cover for drugs. The coverage gap begins after you and your drug plan have spent a certain amount for covered drugs. This amount changes from year to year. People with Medicare who get Extra Help paying Part D costs won’t enter the coverage gap.
Once you reach the coverage gap, you’ll pay a percentage of the Prescription Drug plan’s cost for covered brand-name prescription drugs. You get these savings if you buy your prescriptions at a pharmacy or order them through the mail. The discount will come off of the price that your plans have set with the pharmacy for that specific drug.
Although you’ll only pay a percentage of the price for the brand-name drug, 95% of the price will count as out-of-pocket costs which will help you get out of the coverage gap.
You’ll pay a higher percentage of the price for generic drugs during the coverage gap. What you pay for generic drugs during the coverage gap will decrease each year until it reaches 25% in 2020. The coverage for generic drugs works differently from the discount for brand-name drugs. For generic drugs, only the amount you pay will count toward getting you out of the coverage gap.
Choosing a Prescription Drug Plan
It pays to review your Part D coverage every year, especially if you have started taking new drugs. Part D in Wilkes-Barre, and Bloomsburg
Getting financial help
Individuals with annual incomes of less than $17,820 and financial resources of less than $13,640, or married couples with incomes of less than $27,250, might qualify for Extra Help from Medicare to pay their Part D premiums and out-of-pocket drug costs.