The Centers for Medicare and Medicaid Services (CMS) regulate prescription plans. CMS sets standards for prescription plans to follow. Prescription drug costs can be a major part of health care costs during your time on Medicare.

To cover prescriptions, you may have an individual prescription plan or have one included with your Medicare Advantage plan.

Prescription drugs can impact the plan you are currently on or choose to be on. With higher costs to plans, it is best to schedule an appointment with Patriot Insurance Brokers in Waite Park or Elk River to get a comprehensive comparison.

At Patriot Insurance Brokers we will compare all Part D Medicare plan options available, including:

  • Cost of prescription plan
  • Cost of each prescription on each plan.
  • Where you get your prescriptions filled.
  • Whether you are using or able to use a brand name or generic prescription

Medicare has 4 Parts:

  • Original Medicare
    – Part A – Hospital coverage.
    – Part B – Outpatient services.
  • Part C – Medicare Advantage.
  • Part D – Prescription Drug Coverage.

How does Prescription Drug Coverage work?

Someone new to Medicare would have an Initial Enrollment Period (IEP). This period takes place 3 months before the individual’s birthday month, the birthday month, and the three months after the birthday month.

You may have credible coverage through your employer or group plan that allows you to carry that coverage until you retire.

If you have coverage through an employer or group, you need to sign up within 63 days of coming off your employment plan to enroll in a new prescription plan and prevent a late enrollment penalty.

It is important to sign up during this period because those who do not sign up for a prescription plan may be assessed a penalty. Patriot Insurance Brokers will use these points to assist you in finding a plan for your needs.

When can I make changes to Prescription Drug Coverage on my policy?

Those who are on a plan already may change the plan for next year during the Annual Election Period (AEP) running from October 15 through December 15 each year.

Whether you are on a Medicare Supplement Plan (also referred to as Medigap) or on a Medicare Advantage plan, AEP is the timeframe to make changes for the next year.

What are the tiers for Prescription Drug Coverage?

Prescription Drug Coverage is placed in the following tiers on Medicare Prescription Plans.

  1. Preferred Generic – Lowest cost prescription.
  2. Generic – Lower cost prescriptions.
  3. Preferred Brand – Copays can range from medium range to a percent amount for copay.
  4. Brand – High copays.
  5. Specialty – Highest copay and coinsurance.

Having a prescription in tier 1 or tier 2 will lower the cost of prescriptions. On tier 1 or 2 you would be using generic rather than brand name prescriptions.

If someone on a couple low tier prescriptions needed coverage, they could get by with a plan that has a lower monthly premium.

On the other hand, if someone needs coverage and they use brand-name prescriptions with higher tiers, they may pay a higher monthly premium to help cover the higher level of tier prescription coverage.

To help optimize your prescription coverage, contact Patriot Insurance Brokers, and let us help you.

Are Medicare Prescription Drug plans separate from Prescription Drug Coverage?

Medicare Prescription Drug plans are separate, and you would purchase an individual prescription plan when you have a Medicare Supplement Plan.

There are many prescription plans available to choose from, which also means there are many levels of monthly premiums available.

It is nice to have more options with the Medicare Supplement plan because you can choose from many different prescription plans to cover your needs. Medicare Advantage plans include prescription coverage as part of the plan.

You are not able to buy a separate prescription plan if you have an advantage plan.

If this is what you are looking for, our team can help you find a Medicare Advantage plan which best fits your needs and offers the best prescription coverage for you.

Find the Best Drug Coverage from Trusted Companies

Whether you are looking for a Medicare Supplement Plan, Medicare Advantage Plan, Prescription Drug Plan, or you are a Veteran looking for more coverage out of the VA (Veterans Affairs) system, dental, and visions, we are here to help you find a plan best for you.

Contact us today by calling (888)-232-2583 for a free no-obligation meeting. We’ll discuss your options and help you find the plan that works best for you.

Patriot Insurance Brokers is here to assist you through these tough decisions.