Prescription Drug Plans For Seniors

Medicare April 13, 2017 0
Prescription Drug Plans For Seniors | Medicare Plan Finder

Prescription Drug Plans For Seniors

You may have noticed by now that Original Medicare (Parts A and B) does not include prescription drugs. Even though it isn’t included in your initial plan, you will encounter penalty fees if you do not purchase a prescription drug plan during your initial eligibility period (up to three months before and after your 65th birthday).

There are a couple ways for you to get the prescription drug coverage that you need.

How To Get A Drug Plan

Medicare Advantage plans encompass Original Medicare (parts A and B) and additional coverage for costs such as dental care and prescription drugs.

Note: Even though Medicare Advantage includes supplemental pieces, it is not the same thing as Medicare Supplements.

If you have Original Medicare, you can also get your prescription drug coverage with a Part D-only plan. Prescription drug plans, or PDPs, can also be purchased as an addition to an MSA (Medicare Savings Account), or PFFS (private-fee-for-service) plan.

What’s Covered?

Each individual plan will have a formulary, or a list of all the prescription drugs that are covered. The list is often divided into tiers according to cost. Keep in mind that your out-of-pocket drug costs will vary according to the plan you choose, whether or not your pharmacy is in your network, and whether or not you are eligible for Medicare Extra Help. Costs will also depend on your premium, deductible ($400 max in 2017), copayments, and coinsurance.

What’s The Donut Hole?

The donut hole is a limit on what your prescription drug plan will cover. It applies to all Medicare clients who don’t have Extra Help. In 2017, the donut hole limit is $3,700.

You will pay for 100% of your drug costs until you hit your deductible, which will be $400 or less. Once you spend your deductible, you will only pay a small percentage of your drug costs. However, once you spend $3,700, you will need to pay much more for your prescription drugs (typically 60% for brand-name drugs and 49% for generic).

Click here for a more in-depth look at the donut hole and tips for saving money on prescription drugs.

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Anastasia Iliou
Anastasia Iliou
Content Marketing Manager at Medicare Plan Finder
Anastasia graduated from Belmont University with a Bachelor's degree in Songwriting. When she's not writing, she's on a mission to visit all 50 states in the U.S (and to date has reached 28). Anastasia loves writing music, hiking, and her pet hedgehog, Luna. She loves animals (but not so much bugs) and spends her free time volunteering for The Elephant Sanctuary in Tennesee.