Houston Chronicle Sunday

TO ADD OR NOT TO ADD Medicare Plan D prescripti­on drug converage

- By Valerie Sweeten | FREELANCE WRITER

According to the medicare.gov article, How to Get Prescripti­on Drug Coverage, its drug coverage helps pay for prescripti­on drugs you need, and most importantl­y, even if you’re not taking prescripti­on medication­s at the present time, it’s recommende­d you consider obtaining Medicare drug coverage.

It is a coverage offered to everyone receiving Medicare.

When you’re first eligible, as well as without creditable prescripti­on drug coverage (such as from an employer or a union), and then decide against Plan D/prescripti­on drug coverage, it’s most likely a late enrollment penalty would be assessed if you decide to obtain the coverage later.

The article also stated that “to get the coverage, you must join a Medicareap­proved plan that actually offers drug coverage. Each plan can vary in cost and specific drugs covered.”

The initial enrollment period to join a drug plan or a Medicare Advantage

Plan begins during the seven-month period that starts three months before the month you turn 65, includes the month you turn 65, and ends three months after the month you turn 65.

There is also a special enrollment period when certain events happen in your life.

How does it Work?

There are two ways to sign up for Medicare drug coverage.

1. The first involves Medicare drug plans, which add coverage to original Medicare, some private fee-for-service plans, other Medicare cost plans and medical savings account plans. To qualify for these, you must have Medicare Part A (hospital insurance) and/ or Medicare Part B (medical insurance) to join that separate Medicare drug plan.

2. The other path is with a Medicare Advantage plan (Part C) or another Medicare health plan that offers drug coverage. With this option, you’ll get all of Part A, Part B and prescripti­on drug

coverage. Note that “you must have Part A and Part B to join a Medicare Advantage plan, and not all of these plans offer drug coverage,” according to medicare.gov.

Next, do the research to understand fully what prescripti­ons are covered to make sure this meets your needs.

Medicare.gov also has a page dedicated to this topic titled, What Medicare

Part D Drug Plans Cover.

It explains that all plans must cover a wide range of prescripti­ons that many people take, including most in such “protected classes” such as those that are for HIV/AIDS and to treat cancer.

There is a wide variety of drugs covered under a formulary, or that plan’s overall list of covered drugs. Then, formularie­s have tiers of drugs within them that vary in cost.

For example, a lower-tier drug generally will cost you less than one on a higher tier. Check out various plans at medicare.gov/plan-compare.

Your long-term care facility

According to medicare.gov, long-term care pharmacies contract with Medicare drug plans to offer drug coverage to residents, for convenienc­e.

If you're entering, living in, or leaving a nursing home, you'll have the opportunit­y to choose or switch your Medicare drug plan. This allows you to choose a plan that contracts with your nursing home's pharmacy.

And, to find out how Medicare Part D can work with other insurance coverages, go to www. medicare.gov/drug-coveragepa­rt-d/how-part-d-workswith-other-insurance.

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