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Medicare Part D is a fundamental part of many people’s health insurance. It provides prescription drug coverage and is one of the four parts of Medicare. Understanding prescription drug coverage goes hand in hand with understanding how Medicare operates.
While some prescription drugs are covered through Part B, Medicare intends Part D to be the primary source for prescription drug coverage. Part D is divided up into different tiers, each of which covers a different area of medication.
Prescription drug coverage is important for multiple reasons. Medication can be extremely expensive. Enrolling in Part D is an excellent way to protect yourself from those costs and be sure you’ll be prepared if you need to take a trip to the pharmacy.
Even if you don’t currently take any medications, you should still consider Part D. Common conditions, such as diabetes, can require thousands of dollars worth of supplies and treatments. You never know when you might wish you had enrolled in Part D, so don’t wait until that moment. Reach out now and speak with an insurance professional about what it would mean for you to enroll in Medicare Part D.
Those enrolled in Part C are not eligible for Part D. This is because prescription drug coverage can be added into Part C. If you’re happy with your Original Medicare policy, or are interested in making a change, consider what Part D offers. Part D divides prescription drug coverage into four tiers, each corresponding to a different level of medication
The four drug tiers provide an excellent design for selecting coverage and ensuring the drugs you need are included in your policy. Each tier provides a varying level of coverage. It’s important to remember that the drugs within each tier can change, but more on that later.
Tier 1 is the least expensive option. Its copayment is extremely affordable for most. It covers generic drugs, but still can significantly reduce costs. Even common medications can be expensive, so enrolling in Tier 1 is an excellent way to make sure those costs are manageable. Tier 1 is most likely the best option for those looking for general medication coverage. It’s not intended for those with specialized medication but can suffice if you don’t regularly take complex medications and are looking for generalized drug coverage.
Tier 2 offers more drug coverage than the former, as it includes preferred medication. Brand-name accessibility is also offered through Tier 2. This option is a step up from the first tier and its copayment reflects that. When it comes to drug coverage, copayment and complexity will increase simultaneously.
Tier 3 has the second to highest copayment and that is reflected in the drug coverage. It includes expensive prescription drugs. If you regularly take a high-cost medication, this is most likely the right option for you. It will provide you with exceptional coverage and provide for the cost of most medications. With this coverage selection, you won’t need to worry about the cost of most medications and will have access to the prescriptions you need.
The Specialty Tier is the highest tier available and it has the most expensive copayment. If you’re looking for holistic medication coverage, regardless of how preferred the prescription is, this is most likely the right option for you. While the copayment is high, its extensive offerings make it worth it for most. If you’re anticipating needing an expensive medication, consider enrolling in this tier and gaining access to the coverage it provides.
Choosing a Part D policy is fairly simple for many. By taking a look at the different tiers, you can see which medications are covered. While you should primarily pick based on the medications you currently take regularly, keep in mind your past medical coverage. Was there a time when you wish a certain medication had been covered? If so, consider picking a tier that includes it.
Keeping the future in mind is important when making insurance decisions. Any health problems you’ve had in the past should be taken into account, as it’s possible they could come back. Insurance is all about planning for the future, so make sure to think about all the possibilities and select your coverage accordingly. Remember to take a look at the specific tiers and formularies included with Part D. This is essential in making sure that you know what coverage you’re selecting and the medication it includes.
Medicare Part D plans can change every single year. While there are a few reasons for this, it’s primarily because new medications and therapies are continually released. Medicare shifts and evolves with the healthcare field, so it makes complete sense that prescription drug policies would change as well.
If your Part D plan has changed and no longer includes the medication you need, speak with an insurance agent about your options. You can also reach out to your doctor and see if they have any recommendations. Even though your previous medication may no longer be covered, there may be a comparable one that’s now included within your policy. Speaking with your primary care provider is an excellent way to make sure your insurance and medications are working together to keep you healthy and your bills manageable.
If your drug plan is going to change, you’ll be given notice. You’ll be given written notice that explains the prescription you use is no longer going to be covered. This is incredibly important to watch out for and take seriously. It could mean that you need to change plans and reevaluate your coverage.
You deserve to have drug coverage for the medication you need. If you no longer have coverage in an area, speak with your insurance provider about what can be done. Don’t settle for less and make sure that you have access to the medication you need.
It’s possible to be simultaneously enrolled in Medicare and VA benefits. In fact, for those eligible, this may be the best option. It can lower bills and grant access to various treatment options and centers.
If you’re using both types of benefits for your general healthcare needs, know that won’t be possible when purchasing prescription drugs. You can only use one type of coverage for one drug at a time. For example, you can’t use your VA benefits for one drug and then have Medicare cover any remaining cost you’ll need to pay. While you can use VA benefits and Medicare in that way for other health services, it’s not possible when purchasing medications. You can still be enrolled in both and use both kinds of coverage for medications, just not at the same time.
If you still have questions about VA benefits and Medicare, don’t hesitate to reach out. Our professionals at First Guard are leaders in the Senior Citizen insurance field and understand the importance of knowing the details of your policy and how it interacts with other types of insurance. Before making any big decisions, give us a call and set up an appointment to ask your questions and get the clarification you need.
Whether you’re just beginning your Medicare journey or starting to look into other options, we’re here to help. Our team at First Guard has extensive training in the details of Medicare and understands the importance of having all your questions answered. We’re here to help you through the initial enrollment process and will also be here if you need to make any changes to your policy in the future.
Making an appointment with us means gaining access to one of the most hands on and direct care insurance agencies. We look forward to hearing from you and partnering to ensure you have the best policy for your situation.
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