Navigating the Medicare system can be confusing and difficult, especially when it comes to choosing a new Part D plan. Medicare Part D refers to the optional prescription drug coverage that individuals sign up for each year. Signing up for a Part D plan can be overwhelming. However, we at Sona Pharmacy are here to help. To start things off, let’s go over some of the basics of Medicare.
Medicare comes in a few basic forms: Parts A, B, C, & D. In general, everyone who is 65 and older receive Medicare Part A automatically and has the option to add Part B (aka the “red, white, and blue card”). Part A covers expenses like hospitalization, nursing home care, etc.; while Part B covers physician office visits, durable medical equipment, ambulance services, mental health services, and a few prescription drugs (i.e. transplant drugs, flu shots, pneumonia shots, and nebulizer solution). This is not an exhaustive list of what the aforementioned parts cover, but serves as a very simplistic guide to help understand Medicare.
Part C refers to Medicare Advantage plans. Advantage plans are administered by a third party contractor and cover everything traditional Medicare Parts A and B cover, while generally offering additional benefits such as vision, dental, or more comprehensive medical coverage. These plans often cover prescription medications as well. Advantage plans can be a convenient way to have all your coverage combined into one package and administered through one company. Signing up with an advantage plan will typically cost more in premiums, but can save money in out of pocket costs throughout the year. It is also important to note that if you sign up for a Medicare Advantage plan, you will still have to pay the monthly Part B premium.
Part D refers to prescription drug coverage. When you turn 65 or receive Medicare coverage, you have a 7 month time frame (3 months before and after the month in which you turn 65) to enroll in a Part D plan. If you choose not to enroll in a Medicare Part D plan when you are initially eligible, you have to pay a penalty if you wish to enroll in a Part D plan later in life. Part D plans are administered through third party companies and Medicare recipients must re-enroll in these plans annually. The annual open enrollment period runs from October 15th to December 7th. During this period, you get to pick the plan that will give you prescription coverage over the following calendar year.
Be on the lookout for our next blog post this week for a detailed explanation of how we at Sona Pharmacy help Medicare beneficiaries choose the best part D plan each year during open enrollment!