A Publication of WTVP

Do you know someone who is…

* Struggling with health care expenses?
* Overwhelmed with paperwork?
* In the coverage gap and paying 100 percent of their prescription costs?

Perhaps it is someone special, such as a parent, grandparent, aunt, uncle or neighbor?

It’s that time of the year again—November 15th to December 31st is the Annual Election Period, during which all Medicare beneficiaries can make a plan change. Medicare Part D is an important part of this decision.

Medicare Part D is prescription drug coverage available for people who are currently entitled to Medicare Part A and Medicare Part B. Part D is intended to protect Medicare beneficiaries from high out-of-pocket costs on their prescription drug coverage. And, in fact, the coverage offered to beneficiaries during the past two years has been truly significant, saving hundreds of thousands of dollars each year for beneficiaries who have chronic medical conditions.

Insurance companies which have been approved by Medicare are contracted to offer Medicare Part D plans. A senior can opt for a Part D Plan (PDP), which is a stand-alone prescription drug coverage option with no medical insurance. One may also opt for comprehensive medical and prescription coverage through a Medicare Advantage Part D Plan (MA-PDP).

There are many Medicare Part D options available, all of which are different from each other. Each individual must find the plan which best meets his/her individual needs. Medicare PDPs may or may not have an annual deductible, a prescription drug coverage gap (also referred to as the “donut hole”) or a monthly premium. When making an annual election, it is up to the consumer to determine his/her yearly prescription drug needs and decide whether he/she will require coverage through the gap. Each Medicare Part D plan has a formulary—a list of drugs covered by the plan—and it must meet Medicare requirements. However, each plan’s formulary may differ.

Medicare beneficiaries who wish to receive assistance in finding Medicare Part D options in their area can call 1-800 MEDICARE (1-800-663-4227). TTY users should call 1-877-486-2048. You can visit or call your local State Health Insurance Assistance Program (SHIP). There are also local insurance companies which can assist Medicare beneficiaries with these decisions. IBI