MEDICARE PART D: PRESCRIPTION DRUG INSURANCE

Two Types of Medicare Insurance Coverage

I. Medicare Prescription Drug Plans (PDP) or stand alone plans that adds drug coverage for those with:

Original Medicare Health Care Plan
H, I, or J Medigap (Enhanced) Health Care Plans
Some Private Fee-for-Service Plans
Some Medicare Medical Savings Account (MSA) Plans

A plan membership card is used at the pharmacy of your
choice to purchase prescriptions. Must be enrolled in Medicare
Part A or B to enroll in a Part D prescription drug plan.

Look for comparison of stand-alone plans.

II. Medicare Advantage Prescription Plans (managed care plans that provide health and drug coverage):

Health Maintenance Organizations (HMO)
Preferred Provider Organizations (PPO)
Private Fee-For-Service (PFFS) Plans
Medicare Medical Savings Account (MSA) Plans
Medicare Special Needs Plans (SNP)

Offers prescription drug coverage as part of the overall health care medical insurance plan approved by Medicare but run by private companies. As a person with Medicare under a Medicare Advantage Plan:

•  All your Medicare-covered health care comes through that plan.

•  You may get extra benefits, such as coverage for vision, hearing, dental, and/or health and wellness programs.

•  You usually have to pay some other costs (such as co-payments or coinsurance) for the services you get. Out-of-pocket costs in these plans are generally lower than in the Original Medicare Plan, but vary by the services you use.

•  You may have to see doctors that belong to the plan or go to certain hospitals to get covered services.

•  You don't need to buy a Medigap policy.

Look for comparison of managed-care plans at “Medicare Options Compare Help.”

More Information

“ Comparing Medicare Prescription Drug Coverage “ [CMS Pub. No. 11110 – June 2006]

Important Dates
Get Help
Already Enrolled or Not Taking Prescription Drugs
Getting ‘Extra Help' — qualifications & application
Keeping Your ‘Extra Help'
Two Types of Prescription Drugs Plans
Personalized Prescription Drug Insurance Coverage
Plan Finder Comparison Tool
Plan Restrictions
Bar Graphs of Monthly Costs
Payment of Premiums
Enrollment — with and without penalty
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