Medicare part D is the newest addition to the family of Medicare policy coverage. Medicare part A and B were the original selections for those receiving Medicare. Part A was free and covered nothing more than the cost of the hospital, some coverage for skilled nursing care if you came directly from the hospital, hospice and some home health care. Part B covered all other types of health care, except prescriptions.
While there were out of pocket expenses and coinsurance costs, often a good Medicare supplement covered these payments. However, there still were some gaps. Some people liked managed care plans and felt that a cost saving managed care should be available for them. Congress agreed and passed Medicare part C for Medicare Advantage plans.
Because of the cost savings of managed care and federal subsidies, often these plans contained many additional benefits. One of them was a payment for prescription drugs. Prescription drugs are often on of the higher costs for medical care that come directly from the pocket of seniors since Medicare contained no provision for payment for the month-to-month prescription costs. Even though a few of the Medicare supplements had some provision for prescription drugs, the amount was quite limited if there was any at all.
Congress then enacted Medicare part D. This plan was strictly for prescription drugs and available to anyone that carried Medicare part A and B. It was an attempt to offset the high cost of prescription drugs for seniors at an affordable price.
The basics of the drug plan had a list of minimum coverage that each insurance company carrying the plan had to include. However, if the insurance companies chose to broaden the coverage, that was acceptable under the law. In many cases, companies did so to make their package more attractive to consumers.
Every plan has different deductibles, if any, co-pays, preferred providers and payment for specific drugs. In some cases, providers included drugs, such as Viagra, in their package even though those for erectile dysfunction were not required as part of the policy according to the bill passed in Congress.
In order to find the best Medicare part D for your situation, you need to consider first whether there are convenient preferred providers for the plan. If there is no local pharmacy or mail order available in the plan, no matter how inexpensive the treatment, it’s simply not practical.
Next, take a look at not only the co-pay for the prescription drugs you take on a regular basis, but the number of days the policy considers as one prescription. If one policy has a $20 co-pay for 90 days of drugs and the other has a $10 co-pay for 30 days of drugs, it makes sense that the 90 day prescription is far cheaper and leaves you only paying $80 in co-pays for the year, compared to $120 you’d pay for the other plan.
Finally, compare all of the out of pocket expenses. Include not only deductibles and co-pays but also the actual cost of the plan. The one with the lowest annual cost, consider all factors, should be the one you select. There are other considerations, such as the “donut hole” for those that run past the minimum coverage before the end of the year, to look at if you have high amounts of prescription drug costs throughout the year.
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