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What are my Medicare prescription drug options?

by Jenny Fliegel

Did you or a loved one recently turn 65? Are you approaching your 65th birthday? Now is the time to prepare for Medicare.

You might be surprised to learn that Original Medicare – Parts A & B – doesn’t cover prescription drugs. But between plan types with multiple names and a variety of options to choose from, finding the right prescription drug coverage can be confusing.

It’s important to know that all Medicare-eligible individuals are entitled to prescription drug coverage, regardless of income. Fortunately, you cannot be denied for health reasons, income, or due to the fact that you take a variety of prescription drugs.Medicare

Even if you aren’t currently taking prescription drugs, keep in mind that these plans will give you the peace of mind that you have coverage if you suddenly need it. Before you decide whether or not to sign up for Medicare prescription drug coverage, it’s important to understand all of your options.

You need Parts A & B before moving on to Part D.

To get prescription drug coverage, you can either enroll in a Medicare Advantage plan (Part C) or a Medicare Prescription Drug plan (Part D). However, be aware that in order to be eligible for Part C, you must first have Original Medicare, which is both Parts A & B.

Original Medicare covers hospital and basic medical care. Although you may be automatically enrolled in Part A once you turn 65, you may not know that you will likely need to actively enroll in Part B. To enroll in Part B, you should contact your local Social Security office.

Option 1: Medicare Advantage plan (Part C)

One option to help you get prescription drug coverage is to choose a Medicare Advantage plan, or Part C. If you choose to enroll in a Medicare Advantage plan, you’ll receive your Medicare benefits in one package, usually through a Preferred Provider Organization (PPO) or Health Maintenance Organization (HMO).

Medicare Advantage plans are required to cover all the same benefits as Original Medicare, while also offering additional benefits, such as prescription drug coverage and the possibility of lower copayments. You may notice differences in out-of-pocket costs with Plan C in comparison to Original Medicare.

Option 2: Medicare Prescription Drug plan (Part D)

If you’re looking for prescription drug coverage, you can also choose to enroll in a Medicare Prescription Drug plan, or Part D. Medicare Part D is a stand-alone plan that provides outpatient prescription drug coverage. You can simple add Part D to the coverage you have already.

Before choosing between Part C and Part D, review your specific prescription drugs. Each Part D plan may vary not only in cost, but also in specific covered drugs.

Option 3: Medicare Supplement

While they don’t necessarily cover specific prescription drug costs, Medicare Supplement plans fill in the gap for some costs that aren’t covered by Original Medicare. These plans can complete your coverage by helping you pay for out-of-pocket expenses such as deductibles, copayments, and coinsurance.

It’s important to keep in mind that you cannot have a Medicare Supplement plan and Part C at the same time.

Medicare has neither reviewed nor endorsed this information.

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