Medicare Advantage Prescription Drug

Medicare Advantage plans with Prescription Drug (MA-PDs)

Medicare offers prescription drug coverage to everyone with Medicare. To get it you must join a plan run by an insurance company or other private company approved by Medicare. Each plan can vary in cost and drugs covered.  There are two ways to get it.

You Can Get Coverage through Medicare Prescription Drug Plans (PDPs)

These plans add drug coverage to Original Medicare, some Medicare Cost Plans and some Medicare Private Fee-for-Service (PFFS) Plans.

You Can Get Coverage through Medicare Advantage Plans.

Medicare Advantage Plans provide you with all of your Part A and Part B coverage, and prescription drug coverage (Part D) and are sometimes referred to as “MA-PDs.” You must have Part A and Part B to join a Medicare Advantage Plan.

Most Medicare Prescription Drug Plans Charge a Monthly Premium.

Monthly premium amounts vary widely, from plans that charge $0 monthly premiums to those that offer enhanced benefits for a higher monthly premium. Whatever amount of premium you pay, drug plans have to provide at least a standard level of coverage, which Medicare sets.   Drug plans vary in what prescription drugs are covered, how much you have to pay, and which pharmacies you can use.   The one that’s best for you depends on what you need and how much you want to pay.

You’ll also Have to Pay a Yearly Deductible and Make Copayments for Drugs

Most plans require you to pay a deductible each year before Medicare begins covering part of your drug costs.  Once you meet your deductible and your drug coverage begins, you’ll pay a copayment for your part of the cost of your drugs.  Some plans require different amounts of copayments for different types of drugs.

You Will Temporarily Have to Pay More for Drugs During the Coverage Gap

This coverage gap is also called the “donut hole”.  The coverage gap begins after you and your drug plan together have spent a certain amount for covered drugs.  In 2017, once you enter the coverage gap, you’ll pay 40% of the plan’s cost for covered brand-name drugs and pay 51% of the plan’s cost for covered generic drugs until you reach the end of the coverage gap.

If Your Out Of Pocket Expenses Reach in 2017, You’ll Automatically Get Catastrophic Coverage

If you qualify for Catastrophic Coverage, you’ll have to pay either 5% of the drug’s cost or a $2.60 co-payment (whichever is greater) for generic medications and $6.50 for brand-name drugs. In addition to the 50% discount on covered brand-name prescription drugs, there will be increasing savings for you in the coverage gap each year until the gap is closed in 2020.

Request a quote from e-TeleQuote today to understand the best coverage for your prescription drug needs.