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Medicare Part D Basics

Posted Feb 24th, 2012 by Patient Assistance Team

Perhaps the most confusing portion of the Medicare health insurance program, Medicare Part D is the part of the program that provides assistance for medications. According to the government, Medicare offers prescription drug coverage to everyone with Medicare. If you decide not to join a Medicare drug plan when you’re first eligible, and you don’t have other creditable prescription drug coverage, or you don’t get Extra Help, you’ll likely pay a late enrollment penalty. 

To get Medicare prescription drug coverage, you must join a plan run by an insurance company or other private company approved by Medicare. Each plan can vary in cost and drugs covered.

There are essentially two ways to get Medicare prescription drug coverage.

Keep in mind that both types of plans are called “Medicare drug plans.”  In either case you must live in the service area of the Medicare drug plan you want to join.

The first way is to get a Medicare Prescription Drug Plan. These plans are sometimes referred to as “PDPs, supplement drug coverage to original Medicare and some Medicare costs plans as well as private fee-for-services (PFFS) plans and Medicare Medical Savings Account (MSA) Plans.

The second way is to get a Medicare advantage plan, like an HMO or PPO or other Medicare health plans that offer prescription drug coverage for Medicare recipients. In this plan, you receive all of your Part A and B coverage, and prescription drug coverage (Part D), through these plans. Medicare Advantage Plans with prescription drug coverage are sometimes called “MA-PDs.” In order to be eligible for a Medicare advantage plan, you must first have Part A and Part B.

If you have questions about understanding Plan D, you can work with a health insurance agent who specialize in Medicare insurance plans or you can also reach out to your medical provider who can help guide you to making the right choices for your health needs.