How to Know if Medicare Part D is Right for You

Written By Alla Levin
April 20, 2020

How to Know if Medicare Part D is Right for You

Getting ready for retirement means planning how you’ll not only cover day-to-day expenses but how you’ll cover healthcare expenses.

Most people nearing retirement age consider Medicare for their health insurance needs but don’t fully understand what each type of Medicare plan covers.

Nearly nine in ten (89%) adults 65 and older report they are currently taking any prescription medicine, according to Kaiser Family Foundation data.

Whichever plan you choose, you’ll likely need prescription drug coverage. Medicare Part D can help you afford the medications you need to stay healthy.

Let’s go over what each part of Medicare covers so you can determine whether Medicare Part D is right for you based on your individual lifestyle and circumstances.

What is Medicare?

Medicare is a low-cost federal insurance program generally for people over the age of 65 and is offered in four different parts: Parts A-D.

Medicare Part A: This plan covers home health care, inpatient hospital care, skilled nursing facility care, and hospice care.

However, Medicare doesn’t typically pay the entire cost of your care, which means you’ll have to come out-of-pocket to make up the difference.

Medicare Part B: This plan covers doctor’s visits, outpatient procedures and care, medical equipment, cancer treatment, and cardiac rehabilitation.

Part B is required if you don’t have coverage from another source, such as a union or employer (or your spouse’s employer).

Medicare Part C: This plan is known as Medicare Advantage and covers the same things as Medicare Parts A and B, and usually Part D as well.

Part C is available through private Medicare-approved insurance companies, and you should qualify as long as you don’t have End-Stage Renal Disease (ESRD).

Medicare Part D: This plan only covers prescription medications. There are several ways to get Medicare Part D. You can get this benefit through

Anthem’s cost-effective Medicare Advantage plans or you can add a prescription drug plan separately to your Original Medicare or Medicare Supplement plan.

How Much Does Part D Cost?What is Medicare

If you’ve never had a Part D plan before, you might be wondering about the cost, which depends on factors like how much money you make and the plan you select.

Some of the associated costs include things like copays or coinsurance, deductibles, premiums, and coverage limits.

While there’s no exact number that can determine your exact costs, you can get help paying for your prescription medications if you need it.

There’s a federal program called Extra Help that provides coverage for Medicare Part D costs.

But in order to qualify, you have to already have Original Medicare, be located in the United States, and have a total combined income (including assets) of less than $13,640 as an individual or $27,150 if you have a spouse.

The best part is that if you qualify for this program, you can enroll in Medicare Part D whenever you want and avoid late enrollment fees.

As you’ve learned, nearly 89 percent of people over the age of 65 use prescription drugs by the time they’re eligible for Medicare.

Part D can be a cost-effective option for those who need it.

Is Medicare Part D Right for Me?

Medicare Part D might be right for you if you’re already enrolled in Original Medicare (Parts A and B). If you don’t currently have any prescription drug coverage through a union or an employer, or if you want to lower your prescription drug costs.

It might also be right for you if you want to be covered for prescription medications you think you might need in the future (even if you aren’t taking any right now) or if you have a Medicare Supplement plan.

You might not need Medicare Part D if you’re already signed up for a Medicare Advantage plan that provides prescription drug coverage or you already have coverage through an employer, former employer, or a union.

Getting CoverageIs Medicare Part D Right for Me

Learning all that you can about healthcare and its associated costs can be beneficial so that you’re prepared when it comes time to retire.

Comparing plans and considering the different ways to get prescription drug coverage can help you find just what you’re looking for and make the transition into retirement easier.

Medicare Part D is an ideal option for eligible candidates, so take the time to consider the value it can provide to you or your loved one.

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