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Medicare Part D Enrollment. By Our June Student Pharmacist, Rebecca Rady.

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Summer is here and the sun is shining, but autumn is right around the corner! Along with Buckeye football season and leaves that change colors, autumn is the time of year when Medicare patients can choose whether or not to enroll in a plan that has prescription drug coverage, Medicare Part D.

How is Medicare Structured?

There are many different components of Medicare and hundreds of different plans that Medicare patients can be enrolled in. All of these options can make it confusing for patients to understand how their insurance coverage works, so we wanted to break it down and explain how Medicare patients can get insurance coverage for their prescription medications. You may have heard of the different “Parts” of Medicare:

  • Medicare Part A: Inpatient hospitalization
  • Medicare Part B: Outpatient doctor visits, medical equipment
  • Medicare Part C: Hospitalization, doctor visits, and prescription drug coverage
  • Medicare Part D: Prescription Drug Coverage

A Medicare patient can have Medicare Parts A and B (with or without D) or Medicare Part C. What makes Medicare Part D different from the rest of Medicare coverage is that it is up to the patient to decide whether or not to enroll in a Part D plan and the plan selection is left up to the patient.

How do I get Medicare Prescription Drug Coverage?

From October 15th to December 7th, Medicare has what is called an “open enrollment window” when new Medicare patients can select a prescription drug plan or current Medicare patients can choose to switch into a different prescription drug plan. In most cases people can only elect/change plans during this time period; however, there are exceptions to this time limit such as if the patient moves far away from their current home, has a significant change in health status, or has a change in other types of insurance coverage.

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Patients who are thinking about enrolling in a Medicare Part D plan have a lot of options and doing a little homework by shopping around for different plans can help patients save a lot of money and select a plan that best fits his/her needs.

On the website Medicare.gov, patients can enter what prescription medications that they take and get price quotes on plan premiums (the monthly or yearly cost the patient is responsible for) and copays (the cost the patient is responsible for per prescription filled). This tool allows patients to determine what plan would save them the most money and can help patients budget their health care finances by estimating patients’ annual drug costs.

Additionally, patients can also evaluate Medicare Part D plans by their Star Ratings. The highest rating a plan can receive is 5 stars and plans with more stars have greater patient satisfaction in areas including customer service, member complaints/choosing to leave the plan, member experience, drug pricing, and patient safety.

Medicare.gov has the most information readily available for patients to evaluate different plans they are eligible for and make an informed decision. Patients can select a plan right from the medicare.gov website or they can also enroll by calling 1-800-MEDICARE or by attending a local community event that has professionals on site who can help patients select a plan and enroll.

 

 

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