Choosing the right prescription drug coverage comes down to how you want to manage your health insurance. Are you interested in additional benefit options? How specialized are your prescription medications? The answers to these questions can help you decide which type of insurance plan you need.
Part D Coverage
Medicare Part D plans are stand-alone prescription drug plans often added to Original Medicare Part A and Part B. These plans are offered by private Medicare-approved health insurance companies. The plans have been standardized, but each plan has its own list of covered drugs. A plan’s list of covered drugs is called a formulary.
Each plan covers at least two drugs in each of the most commonly prescribed classes of drugs. These include nearly all anticancer, anticonvulsant, antidepressant, antipsychotic, antiretroviral, and immunosuppressant drugs.
If you are prescribed a drug that is not listed on your plan’s formulary and it cannot be substituted by another drug on the formulary, you and your prescriber can request an exemption to allow coverage for the prescribed drug. The same procedure works if you are prescribed a higher quantity than the limit allows.
For Part D, you will pay a monthly premium, a deductible, and copayments for each prescription at the pharmacy. Copayments for your prescriptions are based on whether your prescription is generic or brand-name, preferred or non-preferred, or specialty.
Medicare Advantage Prescription Drug Coverage
Medicare Advantage Prescription Drug plans are a combination plan type that handles your Part A, Part B, and Part D coverage. These plans are also offered by private health insurance companies approved by Medicare to handle your coverage.
Medicare Advantage plans often offer additional coverage packages for things that Medicare does not cover. This can include dental, vision, and hearing care. These areas of health are vital to your quality of life. Most plans offer these for an additional cost, making your premiums slightly higher for each installment.
When you have a Medicare Advantage plan, you continue to pay your monthly Medicare Part A and Medicare Part B premiums. In addition to this, you will pay a plan premium, a yearly deductible, copayments, and coinsurance.
The prescription drug coverage under a Medicare Advantage Prescription Drug plan is equivalent to the coverage of a Part D plan, although each plan will cover different drugs.
Plan Comparison
If you take prescription medications that are name-brand or specialty (requiring special handling or administration), you may have more difficulty finding a Medicare Advantage plan that covers your medication. You would be more likely to find a Part D plan that covers your medication because there are more options available to choose from and compare the drug prices directly.
If you value the convenience of having the combined plan and having one provider for all of your health insurance needs, a Medicare Advantage Prescription Drug plan may be for you. If you want the option to purchase additional coverage for your dental, vision, or hearing needs, a Medicare Advantage Prescription Drug plan can be the right choice.
For help deciding what prescription drug coverage is the best fit for you, contact Senior Savings USA. Our agents are trained to compare plans and help you find the right choice for your budget and healthcare needs.
