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What Is Medicare – How Plan D Can Get You All of Your Prescription Drugs at Little to No Cost

Medicare is the federal insurance program for Americans aged 65 or older, some disabled Americans, and people with end-stage renal disease. This is definitely a good program for many people. The original Medicare plan, is available nationwide, it is a fee-for-service plan administered by the federal government.

It pays for many healthcare services and supplies, but does not pay for all your health care expenses. Generally, you must enroll in Medicare when you are first eligible. If you choose to enroll at a later time, you will pay a late enrollment penalty. If you already have health insurance through an employer or other source, talk to your benefits administrator to determine whether to enroll in Medicare or not, while you have coverage.

Different Parts of Medicare: Medicare has four parts: hospital insurance, known as Part A; health insurance, known as Part B, which provides payments to doctors and related services; and prescription drug coverage, known as Part D. And the third part is all of these services combined.

Using a Private Health Plan: Medicare Part C, offers you the choice of receiving benefits of Medicare A, B and D through a private health plan, like an HMO or PPO. This coverage is called Medicare Advantage. This is nice because it allows you to have all the services in one plan.

Prices of the Plans: Most people do not pay any premium for Part A, because all of the money was taken from their taxes while they were working. There is a monthly premium for Medicare Part B ($93.50 per month, but people with higher incomes higher than $80,000 pay more).

Using Medicare Part D: Usually, you pay a premium if you join the plan for prescription drug coverage. If you do not enroll when you are eligible, your premium will be higher if you join later. Also, once it has passed its first eligibility, you will have to wait for the annual enrollment period (generally, from November 15 to December 31 of each year) to enroll in the prescription drug coverage for Medicare.

Medicare Benefit For Prescription Drugs: In January 2006, the prescription drug coverage (Part D) became available for the first time for Medicare beneficiaries. Through this new benefit, Medicare pays for a portion of the costs of your prescription drugs. This is very helpful to those that don’t have enough to pay for their prescriptions.

What Drugs Are Included? Both prescription drugs that are brand name and generic are covered with participating pharmacies across the country. All people with Medicare are eligible to enroll in this coverage, regardless of income and resources, health status, or current prescription expenses.

Pricing of Part D: If you decide to have this coverage, you can get your prescriptions one of two ways. You can buy an individual drug plan, or you can join a Medicare Advantage plan, like an HMO or PPO. Either way you will pay a monthly premium, which varies according to the plan, the co-insurance or co-payments for drugs in some cases is a yearly deductible which is no more than $300.

Choosing the Right Plan: There are many plans that participate in the Medicare program for prescription drugs. There is wide competition among plans. However, deductibles, pocket expenses, and prescription coverage costs vary greatly among plans. Some plans may offer more coverage and additional drugs for a higher monthly premium.

Getting Plan D With Limited Income: If you have limited income and resources you can qualify for extra help, you may not have to pay a premium or deductible. If you qualify, you get help paying the monthly premium for your Medicare drug plan, the yearly deductible, and prescription co-payments. The amount of aid depends on your income and resources.

Keeping Prescription Drug Coverage: If you already have prescription drug coverage from your employer, former employer or other source, it may be better to maintain that coverage. Contact your benefits administrator to learn how your existing coverage works with the Medicare drug coverage before making a decision.

Talking to Your Employer: If you think it’s better to change your drug plan that you receive through your employer, be sure to check with your employer first. If you leave the coverage you get through your employer and then change your mind, you probably will not be able to return to it for health coverage or prescription drugs.