Beginning January 1, 2006, a prescription drug benefit, called Medicare Part D, was made available. It was created to assist in making drug coverage more affordable for Medicare beneficiaries.
Medicare Prescription Drug Plans are available through private insurance companies that are contracted with Medicare. The Center for Medicare and Medicaid Services created the structure for the Part D plan and the insurance companies must adhere to their guidelines.
Each plan that offers Part D coverage has their own list of drugs that are covered and a tiered formulary that determines the cost of the copays and coinsurance for each drug. There is a network of pharmacies for each plan and some have preferred pharmacies that may offer even lower copays.
Medicare Advantage Plans, also referred to as Medicare Part C, are offered by private insurance companies and include the services of Medicare Part A (hospital insurance) and Medicare Part B (medical insurance), and most plans also include Part D (prescription drug coverage).
Medicare Advantage plans may also provide coverage for other services not included in Original Medicare such as routine dental, vision, hearing, and health and wellness programs.
In order to be eligible to enroll in a Medicare Advantage plan, you must have Medicare Part A & Medicare Part B, live in the plan’s service area, and not have End Stage Renal Disease (kidney failure).
If you enroll in a Medicare Advantage plan, you still have Medicare and must continue to pay your Medicare Part B premium (and Part A premium if you have to pay one).
Medicare Supplement insurance – sometimes referred to as “Medigap” insurance – can help cover costs like deductibles and co-insurance that original Medicare does not cover.
Supplemental insurance is sold by private companies. When you are enrolled in a Medicare Supplement plan, Original Medicare is your primary insurance, and your supplement will pay secondary.
Medicare Supplement policies require the payment of Medicare Part B premium (and Part A premium if you have one). Every Medicare Supplement policy has a monthly premium and the premiums associated with the policies can vary among insurance companies.
If you are on Medicare – or going on Medicare soon – and find yourself feeling more overwhelmed than anything else, you don't have to go it alone! We are here to help you make your Medicare choices go much smoother. Don't know much about Medicare and how it works? We'll go over the ABC's of it, or you can view some videos at: More about Medicare
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