What is Medicare Part D and how much does it cost?
Medicare Part D is prescription drug coverage. Part D benefits can be purchased in two different ways:
- Through a Medicare Advantage program (MAPD)
- Through a stand-alone prescription drug plan (PDP) offered by an outside provider.
Other important information about Part D:
- Costs will vary based on which plan you choose.
- There may be an additional charge depending on your income (see below).
- If you do not apply for coverage when eligible, you may have to pay a penalty.
- You can change your plan during the Annual Coordinated Election Period (October 15 –December 7 each year).
What is the coverage gap for Medicare Part D?
Most Part D programs have what is called a “donut hole,” or coverage gap. This means that after total retail costs for your prescriptions reach $4,020 (for 2020), you will have to pay the full amount until you have paid a total of $6,350 (for 2020). At that point, catastrophic coverage will pick up most ofthe additional prescription drug costs. In 2020, there is assistance for individuals who reach the “donut hole.”You’ll get a 75% discount on brand-name drugs and on generic drugs. You still receive credit for the full cost in meeting the “donut hole” exclusion amount.
Can I change my coverage?
There are certain times of year when you can make changes to the coverage you already have:
1.) During certain open enrollment periods that happen every year from October 15 – December 7.
2.) Under certain circumstances that qualify you for a Special Enrollment Period (SEP), such as the following:
- You move.
- You’re eligible for Medicaid.
- You qualify for extra help with Medicare prescription drug costs.
- You’re getting care in an institution, such as a skilled nursing facility or long-term care hospital.
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