Medicare Prescription Plans

Prescriptions are covered under Medicare Part D. This adds prescription coverage to the original Medicare plan. These plans are offered by private insurance companies approved by Medicare. Some Medicare Advantage Plans also offer prescription drug coverage included with their plans, however, Medicare supplements (also called Medigap) plans do not include any drug coverage.

Generally, you will pay less for most prescription drugs if you are enrolled in a plan. Besides the premium cost, there could also be co-payments, co-insurance and/or deductible costs associated with purchasing prescriptions.

Things to consider

Costs - It is very important to compare not only the premium cost, but also the co-payment specifically for the drugs you are taking. Often times, the co-payments will exceed the premium cost of the plan. In our experience, in order to provide you with the best plan available we need a list of the current prescriptions and dosage of each.

Coverage Limit - This is sometimes referred to as the donut hole. Each plan has an initial coverage limit of at most $2,510 per year for 2008. If what you pay in co-payments and the insurance company pays to the pharmacy add up to that amount you will then be liable 100% of the cost of your prescriptions up until you reach the castrophic limit. Some company will still cover generics, but generally that is not significant.

Penalty - According to current rules, Medicare will require that you pay a penalty if you don’t sign up for a plan when you become eligible. You may sign up when you first become eligible for Medicare (three months before the month you turn age 65 until three months after you turn age 65). If you get Medicare due to a disability, you can join from three months before to three months after your 25th month of cash disability payments. If you don’t sign up when you are first eligible, you may pay a penalty. If you didn’t join when you were first eligible, your next opportunity to join will be from November 15, 2008 to December 31, 2008.

In our opinion, this is the most confusing part of Medicare. In Colorado