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Medicare Part D

Part D, the most recent addition to Medicare, provides prescription drug coverage to Medicare recipients. Part D is available only through private insurance companies, either as an Integrated Medicare Advantage Part D Prescription Drug Plan (MA-PD) or a standalone Prescription Drug Plan (PDP).


  What are the costs associated with Medicare Part D?

Medicare Part D, like all other parts of Medicare, is not free. Each month, you will pay a Part D premium as well a cost each time you purchase medications. The Part D premium will differ between insurance companies and some companies may even offer a $0 premium for an integrated MA-PD. In addition to the premium, some companies have deductibles and co-pays, the amounts of which vary by plan. 

There are many plans available and finding the right plan to fit your needs can be a challenge, we are here to help.

  What is the coverage gap or "donut hole"?

Most Medicare drug plans have a coverage gap (also called the "donut hole"). This means that after you and your drug plan have spent a certain amount of money for covered drugs, you have to pay all costs out -of-pocket for your prescriptions up to a yearly limit.

 

YearCoverage Gap
You Will Pay This Percentage for Brand-name Drugs in the Coverage Gap
You Will Pay This Percentage for Generic Drugs in the Coverage Gap
2011 $2,840 50 Percent
93 Percent
2012 $2,930 50 Percent 86 Percent

 

If you reach the coverage gap, you may get a 50 percent discount on brand-name prescription drugs when you buy them. Some plans cover generic drugs in the donut hole. There will be additional savings in the coverage gap each year through 2020 when the donut hole is closed completely. Read on for the good news about the Part D catastrophic benefit.

  Am I protected against very high out-of-pocket costs (what is the Part D Catastrophic Benefit)?

The good news is that Part D provides protection against catastrophic costs should you need many expensive medications. After reaching your out-of-pocket limit, you leave the gap and enter the catastrophic coverage stage.  You pay a small copayment or coinsurance and your prescription drug plan pays the remainder of the costs for each covered prescription drug until the end of the year with no limit.

  Which plan should I choose?

There are many plans to select from and finding one to meet your needs may require expert, professional advice.  That's where Aon Hewitt Navigators Insurance Services Inc. (formerly known as Senior Educators Insurance Services) comes in. We provide free assistance navigating your Medicare insurance decision. For free help choosing an insurance policy that meets your needs, click here.

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Y0071_MULTIPLAN_12_13370__R_V2, CMS APPROVED, 01/10/2012
Last Changed: 10/21/2011 11:25