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What is Medicare Prescription?

Why do I need Medicare Part D? 

Why do I need Medicare Prescription Part D?


If you take prescription drugs, you should consider Medicare Part D prescription drug coverage. Original Medicare (Parts A and B) doesn't cover most drugs. If you don't have a Medicare Part D plan or other drug coverage, you'll pay for your drugs out of your own pocket, which can really add up. Part D may help lower your prescription drug costs and help protect you against higher costs in the future.

Medicare Part D prescription drug coverage

Each Medicare plan that covers prescription drugs has its own formulary, or list of covered medications. These formularies include coverage of specific generic and brand-name prescription drugs. All plans must cover certain categories of medications, but the specific prescription drugs covered in each category may vary by insurance company and by Medicare plan. Because of this, it’s always a good idea to check the formulary before enrolling in a Medicare Prescription Drug Plan or Medicare Advantage Prescription Drug plan to make sure your specific medications are covered. Also, keep in mind that the formulary may change at any time. You’ll receive notice from your Medicare plan when necessary. All plans must cover at least two prescription drugs per each category and most medications in the anti-psychotics, anti-depressants, immunosuppressants, anti-convulsant, antineoplastic (cancer), and anti-retroviral (HIV/AIDS) categories. Keep in mind that if you fill a prescription that is not in your plan’s formulary, then you may be responsible for the full retail cost of the medication. If your Medicare Prescription Drug Plan or Medicare Advantage Prescription Drug plan doesn’t cover a prescription drug that you and your doctor think you need, you have a right to ask for an exception to get that medication covered.

Medicare Part D prescription drug costs

Because Medicare plans set their own monthly premiums and other out-of-pocket expenses, your Medicare Part D costs may differ by plan, insurance company, and location. In general, each Medicare Prescription Drug Plan and Medicare Advantage Prescription Drug plan requires a monthly premium. Keep in mind that the premium for your Medicare Part D coverage is separate from any monthly premiums you may owe for Medicare Part A or Part B. You’ll need to keep paying your Medicare Part B premium, in addition to any monthly premium required by your Medicare Prescription Drug Plan or Medicare Advantage Prescription Drug plan. If you’re enrolled in a Medicare Advantage plan that includes prescription drug coverage, your plan premium may include the cost for your Medicare Part D coverage. You may pay an extra cost if your income (as reported on your tax return from two years ago) falls above a certain threshold. Also known as the Part D Income-Related Monthly Adjustment Amount (IRMAA), this cost is separate from the monthly premium you may pay for your Part D coverage and may change from year to year. Unlike your Part D monthly premium, you’ll pay the Part D-IRMAA directly to Medicare, not your Medicare plan. You must have an Original Medicare (Parts A and B) plan to qualify.

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How does Medicare Part D work and what are my options?

With Part D, you have two options, contingent that you already have Parts A and B: Receive coverage through a private insurance company (such as Priority Health) that offers a Medicare Advantage plan with prescription drug (MAPD) plans. Get a stand-alone prescription drug plan (PDP).

Why should you consider Medicare Plan D Prescription Drug?

Medicare Part D covers the cost of self-administered prescription drugs. While drugs that are administered by a medical professional during an operation or hospital stay are typically covered by Original Medicare, medications for which patients receive prescriptions, get filled at a pharmacy, and administer themselves are usually covered by Medicare Part D. However, Medicare Part D only covers drugs that are deemed “medically necessary” which means that not all drugs are covered. Some examples of common prescription drugs that are not covered by Medicare Part D include medications used for cosmetic purposes, weight loss or weight gain, erectile dysfunction, fertility, or any drug that has not been approved by the Food and Drug Administration (FDA). In order to receive Medicare Part D, a beneficiary must already be enrolled in Medicare Part A and/or Part B.

  • Cost protection: Part D plans help protect against high-cost prescription drugs by offering various levels of cost coverage for different “tiers” of drugs
  • Low premiums help make these plans affordable
  • Flexible plan options: Part D plans offer you choices in cost and benefit levels depending on your needs and other coverage you may have.
  • Works with Medicare Part A and Part B (Original Medicare), or may be included in a Medicare Advantage plan (Part C)

MENDRE Insurance Group is here to guide you with simple process

Depending on your situation you may need only Medicare A,B or Medicare Plan D Prescription Drug but there are many times when you need both to fully protect yourself. Medicare other plans and Medicare Plan D Prescription Drug work together to help reduce the impact of cost. Let MENDRE Insurance Group help you to understand the complete process in easy way.

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What to ask when buying Medicare Plan D Prescription Drug?

When buying Medicare Plan D Prescription Drug make sure you understand the following. Ask your benefits administrator or insurance agent about anything you don't understand.

General terms and conditions

How the plan defines disability
Are there any exclusions
Are there any pre-existing condition clauses in the plan that you should be aware of

Premiums

How much the policy will cost
Do you still need to make premium payments while living with a disability

Benefits

The amount of money you'll get each month
Are the benefits taxable
Will benefits be adjusted for inflation
How long you need to wait before starting to receive benefits
Does the plan include partial disability benefits
Can you increase your coverage without a medical exam

Individual plans

Is the policy “guaranteed renewable” meaning you have the right to renew the policy, usually without additional evidence

Group plans

Is your group plan provided by an insurance company or is it self-funded by the employer
Will you still get benefits from a self-funded plan if the employer goes bankrupt or faces financial difficulty. If you leave your job, are there provisions to continue your existing coverage until you get new coverage.

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Lump-Sum Benefit

Use your benefit to maintain financial stability, access cutting-edge medical services or to aid your recovery in some other way.

"The Healing Journey" Program

Medicare Plan D Prescription Drug can give you financial security and valuable support services to help cope during a challenging time.

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Step 1
Find an advisor

Medicare Plan D Prescription Drug is a specialized product. Your decision to buy coverage should be made with the help of someone who really understands the product. An advisor can help you determine the right coverage to meet your need to protect your family and your finances. Talk to our expert advisor to help answer your questions. There is no cost to talk to an advisor.

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Meet your advisor

To get the most out of the meeting with your advisor, take some time beforehand to think carefully about what you want to achieve. An advisor can help you determine the right coverage for you. And because your advisor will need additional information to help recommend the policy that’s right for you, get together some basic information about your income, assets and liabilities.

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Step 3
Apply for coverage

Your advisor will handle the paperwork for you. You’ll need to submit an application for a policy that will be evaluated by the insurance company. Depending on your age and the type and amount of coverage you want, you will need to answer a medical questionnaire. You may also be asked to provide additional medical information. MENDRE Insurance Group will help you covered.

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If you are still confuse to choose between different type of insurances. Don't Worry! Let us guide you with simple and easy process and help you find best prices.

We’ll find you which company will give you the least expensive insurance quote possible. Since we have best insurance companies to choose from, we are usually successful at doing that.

Get a free consultation Apply Now Call: 321.557.1307

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Let us help you to find best prices

We’ll find you which company will give you the least expensive insurance quote possible. Since we have best insurance companies to choose from, we are usually successful at doing that.

Get a free consultation Apply Now