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Tell me about Prescription Drugs Plan in Medicare
Part D of Medicare Insurance helps pay for prescription drugs for your health care. Prescription drugs coverage is an insurance policy you buy from private insurance companies. You can buy a standalone separate policy just for drugs, called prescription drugs plan. Alternatively, you can buy Medicare Advantage plan that includes drugs coverage. Medicare has issued guidelines for the type of drugs that must be covered by drug plans and the minimum standards of benefits. Insurance companies design different plans, which conform to or exceed minimum standards set by Part D. These plans vary by cost, and by their formulary, or list of specific drugs covered.
Drug plans have preferred and non-preferred pharmacies to choose from, and the geographical area they are offered. Medicare Advantage plans with prescription drugs coverage have network of pharmacies that go with the plan and set their own pricing structure. Note that within the same network pharmacy, prices will vary. So, shop for the pharmacy store you will hang your hat on for list of medication you are sure to take. As for non-network pharmacies, the retail prices will typically be more; however, you may find discounted prices.
Cost sharing of prescription drugs is designed based on deductible, copayment, coinsurance, and coverage gap, also called ‘donut hole’, when cumulative total of purchase expenses rise about certain levels. Typically, the annual cost share expenses work out as follows for you in a typical Medicare Advantage Plan, which includes prescription drugs coverage:
"We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options."