Community Health

Medicare Part D Information

Who is eligible for Medicare Part D?

Anyone with Medicare is also eligible for prescription drug coverage through Medicare Part D.

How does Medicare Part D work?

If you have a standard Medicare Part D plan, you pay for your first prescriptions out of pocket until you reach your deductible amount. Then you pay your co-pay amount for each prescription until you reach your coverage limit (bottom of the gap). You then pay for 100% of the cost of your prescriptions while you are in the gap. If you reach the catastrophic limit (top of the gap) you pay only 5% co-pay for covered drugs. If you chose and enhanced plan, what you pay may be different.

What are the options for getting Medicare Part D coverage?

You may choose to keep original Medicare and add on drug coverage through a variety of private insurance companies. You can also choose to have your Medicare Parts A, B, And D together in one plan called Medicare Advantage.

What is the difference between standard and enhanced plans?

Enhanced plans may offer additional benefits such as lower co-pays or generic drug coverage while you are in the gap. Enhanced plans will have a higher premium.

What if I can't afford to pay for Medicare Part D?

If you have limited income and cannot afford to pay for Medicare Part D benefits you may qualify for programs such as "Extra Help" from social security and HoosierRx. These programs can help pay for Medicare Part D premiums.

When can I sign up for Medicare Part D?

You may sign up for Medicare Part D during your initial enrollment period starting 3 months prior to the month you turn 65 through 3 months after.  There is also an open enrollment period from November 15 through the end of the year. If you do not sign up when you are first eligible, and do not have credible prescription drug coverage, you may have to pay a penalty in addition to your monthly premium. Picking a plan that is best for you is important and can be done on Medicare's website at www.medicare.gov