When making your Medicare decision, it can be confusing as there are so many parts of Medicare with different letters and plans. If you’ve gone down the Original Medicare path, then you’re going to need a Medicare Part D prescription drug coverage plan.
Why is that?
Let’s get clear.
Since Medicare Part A and Medicare Part B only cover medications that must be administered by a medical professional, such as most chemotherapy treatments, you will want to get a plan that covers your medications.
As a reminder, Medicare rules state:
Once you turn 65, you will face penalties if you don’t have a credible prescription drug coverage.
That means getting a Part D drug plan is one way to get credible coverage.
Here is how Medicare Part D drug plans work:
- Medicare determines the type of medications that every plan must cover. (Some plans will include extra medications, but they’re not required to do so.)
- Once Medicare releases the list of medications that must be covered, the insurance companies will go to the drug companies to negotiate prices.
- Depending on how good of a deal the insurance companies get, it will put the drugs into different tiers. There are usually five different tiers. The first tier is going to be the least expensive, and the fifth tier will be the most costly.
This means the right plan for you will depend on many factors like:
- The medications that you take.
- The tier your medication falls into.
- The premiums.
- The deductibles.
- Which pharmacy you go to.
- Whether or not you hit the $2,000 copay cap.
Please also be aware that these plans change every year.
Medicare hosts an Annual Open Enrollment from October 15th through December 7th.
This is when you could review the new plans, the premiums, the deductibles, the tiering, and the pharmacies to ensure that you have the best plan for the upcoming year.
Everyone can change their plans no matter what state or medical conditions they have. This is critical to review every single year.
In 2024, we reviewed our client’s Part D plans and changed over 60% of our client’s plans to save them on average $2,446 in 2025.
As I have always said, Medicare is complicated, and too many people make the wrong Medicare decision, which is jeopardizing their healthcare and their savings. This is why people turn to the Medicare Coach.
The Medicare Coach is an independent Medicare expert. We are not associated with an insurance company, agent, or broker making our advice completely unbiased.
To get help with your Medicare decision, you can register for my next free online Medicare workshop by going here: https://join.themedicarecoach.com/free-workshop