Medicare Part D

Medicare Part D: What does it cover?

By Sharon A. Burgess

The Medicare program is designed to provide different types of medical coverage.  Medicare Part A (hospital insurance) and Part B (medical insurance) provide medical coverage for hospital, doctor, and medical procedures.  If a person is eligible for Part A and Part B, they can add Part D to their Medicare plan coverage.

Medicare Part D provides coverage for prescription drugs.  This is referred to as a volunteer plan; however, if a person does not enroll in a Medicare Part D prescription plan when they become eligible, they could incur a penalty when they do need to enroll to provide assistance with prescription costs.  The penalty is a 1% increase for each month of coverage not enrolled.

Once enrolled in a Part D plan, a person can make changes to their plan during the open enrollment period.  The open enrollment period for Medicare Part D plans is upon us.  A person can make changes to their current plan during the time period from October 15 until December 7.  Part D plans are offered by private insurance companies.  It is important to review all plans available to you, and the changes in your current plan, as some drugs may no longer be covered in the plan you are currently in.  Additionally, the premium and co-pays for each plan will vary between the different plans.

To make changes to the current plan, make sure to list all current prescriptions to determine if all will be covered and which plan will provide the best coverage.  In determining your total out-of-pocket cost for a plan, it is important to review not only the drugs covered and the premium, but also the co-pays for the various prescriptions.  Some companies will require the use of a generic brand drug, which may or may not be acceptable for your medical care.  It is important to compare plans during the open enrollment period to obtain the best coverage available.

Sharon A. Burgess, Danelle E. Harrington, and Katelyn A. Sweeney practice in the areas of probate/estate planning, long term care planning and elder law, and business and real estate transactions at SMITH BOVILL, P.C.  Their articles are intended to introduce various issues arising within these fields of practice and are not intended to replace individual legal advice.  If you have questions, please contact Sharon, Danelle, or Kateleyn at one of the firm’s two convenient office locations in Frankenmuth and Saginaw.