A blog about Medicare. What you and your employees need to know
Medicare Stew Series –
What is Medicare Part D?
Author: Lora Drummond
Medicare Transition Specialist
Medicare Stew – Part 2: What is Medicare Part D
The Medicare Stew Series continues with a helping of what Medicare Part D covers.
Medicare Part D is coverage to help folks pay for Prescription Drugs. Plans are offered by private insurance companies approved by Medicare. Adding a Part D plan to Original Medicare expands your healthcare coverage. These plans are relatively new to Medicare as the ability to enroll in them only went into effect January 2006.
To qualify for a Part D plan, you must be enrolled in Parts A and B of Medicare.
There is an enrollment sticky point with this part of Medicare. While Medicare doesn’t call enrolling in Part D mandatory, folks who miss certain enrollment periods could end up with lifelong penalties.
This means if you are already 65 and on an employer plan that is creditable, you already have your medications covered. (Your employer plan must have drug coverage at least as good as Medicare). You can then defer your Part D coverage along with Parts A and B. But if you are not on a creditable plan, and turning 65, you need to get Part A, Part B, and Part D. Your initial enrollment period is when you are turning 65. If you miss the enrollment at this time, a penalty may apply later when you do go to enroll.
You can enroll in a Part D plan with Original Medicare, or obtain the coverage through a Medicare Advantage plan that has the drug coverage included. (We will go over only the stand-alone Part D plans with Original Medicare for now.)
Part D plans are geography-specific. That means plans must be selected based on the area a person resides in. Plans may not be offered in all parts of the nation. So when a person enrolls in a plan and moves to another location (state or county) they might need to change their prescription drug plan for coverage in their new location.
Since the Drug plans are offered by private insurance companies, how the coverage and costs apply for the medications you are taking can differ. All prescription drug plans must give at least a standard level of coverage determined by Medicare. So folks will need to compare the all the plans available to them. Compare what and how they cover medications, premiums, and which pharmacies they can go to. Keep in mind, these plans generally change all of that information every year. Similar to when the drug formularies changed with employer group plans.
Just like employer group plans, which drugs are covered, how they are covered, and premium costs can change every year. It is recommended that folks on Medicare Prescription Drug plans review their plans every year to identify changes that might impact them. Medicare’s Annual Enrollment Period (AEP) that starts October 15th to December 7th is the time changes can be made to Medicare Part D. We review all of our client’s prescription drug plans during this period and guide them on options to consider. If you are not working with an advisory firm that provides an annual review for folks you know on Medicare, call us. We are here to help.
Need help with employee Medicare questions now? Want to attend a workshop to learn more about Medicare in a simplified way? Join us and earn a SHRM credit too! Register Here!
The Medicare Architects comprise a unique team of consultants and Certified Medicare Planners®, who utilize industry-first technology, and CMS-approved educational support under 123EasyMedicare to compliantly support your employees with successful Medicare transition.
All resources for Medicare guidance are in one place so it’s easy for your retirees!
Our complimentary partnership provides the best benefit support possible for employees preparing to transition to Medicare.
Let us help take Medicare off your plate in 2022.
Our services are at no charge to you or your employees – We are here to help!
Our Certified Medicare Planners® have more than 20 years of experience helping employees create Medicare transition plans BEFORE they need to enroll. We are ready to help!
Continuing to provide Medicare guidance for your employees in 2022.
Create a compliant Medicare benefit support plan. Give your employees personal guidance from a team of experts that will follow them after they retire.
Plus get early notifications of any NEW helpful resources and Medicare news! SIGN UP BELOW!
Your Medicare Transition Partner
Subscribe to Medicare@work
Other Posts from Medicare@work
Don’t adjust your dial! Our Medicare help for businesses is now more accessible than ever. Stay tuned to your favorite social media sites for links to enjoy helpful topics for guiding employees with their options regarding Medicare. When folks turn 65, they have more healthcare choices. We are here to help!
Medicare Stew – A series simply explaining the main ingredients of Medicare to help your employees. Read about Medicare Supplements (Medigap) Plans.
Medicare Stew – A series simply explaining the main ingredients of Medicare to help your employees. Read what Medicare Advantage Plans are.
Medicare Stew – A short series simply explaining the main ingredients of Medicare to help your employees. Read what Original Medicare is.
Ready to reduce your workload in 2022? Add a team of Medicare experts and education to your benefits team. We make Medicare@Work 123easy!
You are on a vacation with your family in another state. How does your Medicare Advantage plan work in an emergency?
Thank you from The Medicare Architects for trusting us with helping your employees transition stress-free from their group plan to Medicare.
If your employees enroll in Medicare while still working neither they or their employer can continue to contribute to their HSA.
Turning 65 in 2022? Here are are some thing to consider if you will keep working past your birthday and want to keep your employer plan.
Medicare wants to help you stay healthy so there are some options for covering nutrition, fitness, and weight management programs.