You can sign up for Part D Prescription Drug Plans, which helps cover prescription drug costs, along with other components of Medicare starting three months before your 65th birthday.
It's important to do this on time because there's a permanent premium surcharge for enrolling more than three months after your 65th birthday if you don't have equivalent drug coverage from another source, such as a retiree plan.
If you are already enrolled in a Part D "standalone" plan or a Medicare Advantage plan that incorporates drug coverage, you can switch plans during the open-enrollment period, which runs from Oct. 15 to Dec. 7 every year.
Most Prescription Drug Plans have a coverage gap called a donut hole. This means there's a temporary limit on what the drug plan will cover for drugs. The coverage gap begins after you and your drug plan have spent a certain amount for covered drugs. For 2020, you're in the coverage gap once you and your plan have spent $4,020 on covered drugs. People with Medicare who get Extra Help paying Part D costs won’t enter the coverage gap.
Additionally, you'll pay no more than 25% for covered brand-name and generic drugs during the gap.
Year | You'll pay this percentage for brand-name drugs in the coverage gap | You'll pay this percentage for generic drugs in the coverage gap |
---|---|---|
2019 | 25% | 37% |
2020 | 25% | 25% |
For 2020 and beyond, Medicare will pay 75% of the price for generic drugs during the coverage gap, and you'll pay the remaining 25% of the price. The coverage for generic drugs works differently from the discount for brand-name drugs. For generic drugs, only the amount you pay will count toward getting you out of the coverage gap.
It pays to review your Part D coverage every year, especially if you have started taking new drugs.
Call us to help you understand your options.
Individuals with annual incomes of less than $18,210 and financial resources of less than $14,100, or married couples with incomes of less than $28,150, might qualify for Extra Help from Medicare to pay their Part D premiums and out-of-pocket drug costs.
Download Medicare's instructions on applying for the Extra Help program.
Additionally, read about the six ways to lower your drug costs on Medicare.gov.
This information was obtained from www.medicare.gov
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