If you are getting qualified for Medicare and are considering your insurance options, you probably considered your Medicare Part D prescription drug policy. The good news is that you can have many options when choosing a Medicare Part D policy. You must choose the following when choosing a health insurer for your Medicare Part D policy.
How much does the Medicare Part D policy cost?
Medicare Part D policies are provided by private insurance firms with Medicare approval, which means that each company sets its own cost structure. When comparing policy costs, there are three elements to consider: the monthly premium, the annual deductible and the co insurance or co payment structure. Except you receive prescription drug insurance via a Medicare Advantage policy, you usually pay a different monthly premium for your Medicare Part D insurance company.
Your policy may also have an annual deductible, but many policies do not. A deductible is the amount you pay out of pocket before the policy begins to pay. The deductible varies by policy, but cannot exceed the Medicare limit each year. It also has a cost sharing for your insurance. Some policies use a co payment system whereby for each prescription you pay a flat fee. Other policies use co insurance, which is a percentage of the actual cost of the prescription. Many policies use a step-up co pay or co insurance scheme in which you pay a lower amount for less generic prescription drugs and a higher amount for expensive brand-name drugs.
Will Medicare Part D insure all my prescription medications?
All policies must include certain prescription drugs and certain classes of prescription drugs that Medicare requires. In addition, companies can also choose other medications. The list of prescription drugs insured by a Medicare Part D policy is called a “formulary.” Should you regularly take prescription drugs, you should check the regulations that apply to each drug you are interested in to make sure your drugs are insured. The formulary can change at any time, but the policy must notify you when necessary. Quotes for AARP advantage are at https://www.medicareadvantageplans2019.org/aarp-medicare-advantage-plans-for-2019/
If your exact medication is not insured, there will be similar prescription medications in most cases. If your doctor thinks that a particular medication is the only one that’s right for your specific condition, you may need an exception to your policy.
Some policies may have special insurance rules for certain types of drugs. For example, you may need to try a cheaper drug for a while to see how you respond to it before your policy insures a similar drug that is higher. Some policies may require prior approval for certain medications. Your policy may also limit the number of does or pills of medication that you can receive at the same time.
Do I have to use another pharmacy with my Medicare Part D policy?
Some policies use a network of providers to keep costs down for their members. For some cases, the policy may not pay at all when it leaves the provider network.