If you are enrolled in Original Medicare, you won’t have immediate access to prescription drug coverage. To get this benefit, you must purchase a Medicare Part D plan. These Part D plans are sold by private insurance companies that have been approved by Medicare, so you can find them sold by a variety of providers in your area.
If you are looking forward to purchasing a prescription drug plan through Medicare, here’s what you need to know.
What Is Medicare?
Medicare is a public health insurance program that provides coverage to millions of older Americans and people with disabilities. The standard plan under Medicare is Original Medicare, and it does not include prescription drug coverage. You may also choose to enroll in a Medicare Advantage plan — many of these plans do include prescription drug coverage. Though, keep in mind that you cannot purchase a Part D prescription drug plan if you are enrolled in Medicare Advantage. You must acquire your prescription drug coverage through your Advantage plan or another party.
Part D Prescription Drug Coverage
To get prescription drug coverage while enrolled in Original Medicare, you can purchase a Part D prescription drug plan. These plans offer coverage for a range of different prescription medications.
The formulary featured in your Part D plan dictates which prescription drugs are covered and how much they will cost. If the medications you need are not listed in the formulary, you can speak with the plan provider to determine whether they can make an exception for your drugs.
Please be informed that all Part D plans are required to cover at least two medications in each major category. Some of the categories that must be covered by all Part D plans include:
- HIV/AIDS treatments.
- Antipsychotic medications.
- Anticonvulsive treatments for seizure disorders.
- Immunosuppressant drugs.
- Anticancer drugs (unless covered by Part B)
Comparing Part D Plans
If the specific drug you need is not covered under the first plan you find, then you probably should shop around. To find the perfect plan, we suggest you speak with an insurance agent, such as the talented team at Avina Financial Group. We are prepared to help you compare Part D plans in your area, and you can trust us to help you find one that is appropriate for you. Call now to get started.
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