topic Re: Medicare Part D quesion in Community Chat

Medicare Part D quesion

Witchy Woman — Tue, 22 Mar 2016 00:49:25 GMT

I'm hoping this might be a simple question, and I'm trying to sort it out now on the Medicare website but...

I turned 65 last October and, as retired Federal employee, had a decent health care, so I only signed up for Medicare Part B. I didn't switch out of my Federal plan.

What I failed to realize is that health plan had changed drug coverage and now I'm paying a fair amount for drugs that were previously no cost. I'm wondering if I made a mistake not signing up for the Medicare drug coverage.

I'm not even sure if they would pick up any coverage not paid for by my other plan, so it might now even be an option.

Any thoughts?

Re: Medicare Part D quesion

Mz iMac — Tue, 22 Mar 2016 00:54:14 GMT

Check w/your state for Part D drug coverage. Most if not all States have discounted drug coverage.

I pay $5 for all of my drugs through my State's discounted Part D insurance.

Since you are now on Medicare you should have the Medicare & You booklet. The book is customized to the State you domicile in. Check the booklet for all a list of all the discounted drug programs for Part D insurance plans your State has.

Re: Medicare Part D quesion

ROMARY — Tue, 22 Mar 2016 00:55:50 GMT

I don't quite understand 'D' myself......A couple of years ago, I recall neighbors (not next door, but around the corner) wondering what to do, but don't know what they decided/chose to do. They were in an HMO. I might learn something here.

Re: Medicare Part D quesion

Goodie2shoes — Tue, 22 Mar 2016 01:07:33 GMT

Good question, I will be interested in the responses you get. I am retiring in a few weeks, went to SS to sign up for medicare part B but I am waiting for my employer to forward confirmation of my current heathcare coverage to SS before I can get part B. I am considering a supplemental plan and drug coverage is very important as I am on meds for diabetes.

Re: Medicare Part D quesion

Still Raining — Tue, 22 Mar 2016 01:13:00 GMT

As I recall, you can not have Part D as long as you have other drug coverage. You also must be careful not to have a lapse in coverage once you are on Medicare or you will pay a penalty once you switch to Part D. You should check with your current insurance before you apply or drop anything.

Re: Medicare Part D quesion

nomless — Tue, 22 Mar 2016 01:13:04 GMT

Drugs that are covered and their cost varies across plans. The plan d site allows you to enter info like your state of residence, your pharmacy, and the medications you need, and it returns plans that cover those medications and tells you the cost of both the plan and the medications at various pharmacies in your area. That allows you to determine which plans fit your needs.

That said, I don't know how plan d fits in with your current health insurance coverage. Find an independent agent who can help you determine what you are required to have and / or eligible to enroll in. (Those in Medicare are required to be enrolled in a Plan D. If a Medicare participant chooses to not enroll, he/she will pay more for it later for the rest of his/her life.). Your situation is unusual, so seek the advice of a trained advisor.

Re: Medicare Part D quesion

Tinkrbl44 — Tue, 22 Mar 2016 01:31:03 GMT

From what I've heard, Part D is a gift from heaven.

If you have any questions about having some coverge here and other coverage there, PLEASE talk to a licensed agent qualified to steer you through the Medicare maze. The last thing you need is to "think" you're covered and find out some huge bill will be disallowed!

Re: Medicare Part D quesion

Moonchilde — Tue, 22 Mar 2016 01:50:04 GMT

@Goodie2shoes wrote:
Good question, I will be interested in the responses you get. I am retiring in a few weeks, went to SS to sign up for medicare part B but I am waiting for my employer to forward confirmation of my current heathcare coverage to SS before I can get part B. I am considering a supplemental plan and drug coverage is very important as I am on meds for diabetes.

If you join a Medicare Advantage plan, drugs are almost always, or always, included. If you purchase a supplemental plan (I did), you do need to also separately purchase a Part D plan as well. As another poster suggested, google "Part D Yourstate" and you will come up with them.

Go to the websites and put in all of your medications (PIT*) so you will know what each plan covers for *your* medications - they do vary. Then you can make an informed choice.

Re: Medicare Part D quesion

azgal — Tue, 22 Mar 2016 01:52:39 GMT

Remember there is a coverage gap referred to as the donut hole in part D. After you meet a certain amount of money spent on prescriptions they pay a lesser percentage until you reach another amount referred to as catastrophic then they pay 100%, I think.

So it depends on how expensive your prescriptions are.

My husband gets in the donut hole around April so for us the coverage is lousy. We had much better coverage with my employment plan but a couple of years ago they decided to drop medicare eligible people so that's the best we can do.

The donut will close in 2020.

Re: Medicare Part D quesion

Moonchilde — Tue, 22 Mar 2016 01:54:22 GMT

@Tinkrbl44 wrote:
From what I've heard, Part D is a gift from heaven.

If you have any questions about having some coverge here and other coverage there, PLEASE talk to a licensed agent qualified to steer you through the Medicare maze. The last thing you need is to "think" you're covered and find out some huge bill will be disallowed!

I am on all generics (had an HMO while working). I swear that even with my monthly premium for Part D, my co-pays & all come out to slightly less than what my work insurance paid under Blue Shield. I'm definitely not unhappy!

Re: Medicare Part D quesion

Mmsfoxxie — Tue, 22 Mar 2016 17:40:11 GMT

@Witchy Woman, Call the Dept of Aging and ask to speak with an insurance navigator. All will be explained to you.

Re: Medicare Part D quesion

151949 — Tue, 22 Mar 2016 02:37:35 GMT

You should be able to sign up for part D now - you can go to the SS office and they will answer your questions.

Re: Medicare Part D quesion

m2p — Tue, 22 Mar 2016 03:40:55 GMT

Last year or the year before a lot of the formularies covered under Federal health plans changed. Many drugs changed tiers and prices increased. During open enrollment I check the drugs we take against the lists, a pain yes. You shouldn't need part D, but you may have to change plans. Also make sure your doctors and hospital are also in the plan if you change.

The paragraph below is from the Federal Emplyee's Retirement Blog.

"Secondly, you must decide on whether to sign up for the Original Medicare plan (Part A and B) or Medicare Advantage Part C that offers private sector Health Maintenance Organizations (HMOs) or Preferred Provider Organizations (PPOs) coverage. Part D, Medicare’s prescription drug benefit, requires an additional monthly premium and is unnecessary in most cases because our FEHB plans include a comprehensive prescription drug benefit."

Re: Medicare Part D quesion

Goodie2shoes — Tue, 22 Mar 2016 03:51:50 GMT

@Moonchilde, thanks for the information

Re: Medicare Part D quesion

Nuttmeg — Tue, 22 Mar 2016 04:55:51 GMT

@Witchy Woman @m2p wrote:

Last year or the year before a lot of the formularies covered under Federal health plans changed. Many drugs changed tiers and prices increased. During open enrollment I check the drugs we take against the lists, a pain yes. You shouldn't need part D, but you may have to change plans. Also make sure your doctors and hospital are also in the plan if you change.

The paragraph below is from the Federal Emplyee's Retirement Blog.

"Secondly, you must decide on whether to sign up for the Original Medicare plan (Part A and B) or Medicare Advantage Part C that offers private sector Health Maintenance Organizations (HMOs) or Preferred Provider Organizations (PPOs) coverage. Part D, Medicare’s prescription drug benefit, requires an additional monthly premium and is unnecessary in most cases because our FEHB plans include a comprehensive prescription drug benefit."

Please contact your health care provider. You do not want to make a bad choice that maybe permanent.

Re: Medicare Part D quesion

CelticCrafter — Tue, 22 Mar 2016 11:07:46 GMT

Is it a requirement that you have to have Part D or is it an optional coverage?

Re: Medicare Part D quesion

Witchy Woman — Tue, 22 Mar 2016 11:21:56 GMT

@Still Raining wrote:
As I recall, you can not have Part D as long as you have other drug coverage. You also must be careful not to have a lapse in coverage once you are on Medicare or you will pay a penalty once you switch to Part D. You should check with your current insurance before you apply or drop anything.

I'm beginning to think that might be the case, but will check further. My Federal health plan DOES offer drug coverage, so that may be a factor. I was hoping D might pick up the costs NOT covered by my current plan, but I doubt it's going to work that way!

Re: Medicare Part D quesion

Witchy Woman — Tue, 22 Mar 2016 11:25:45 GMT

@m2p wrote:
Last year or the year before a lot of the formularies covered under Federal health plans changed. Many drugs changed tiers and prices increased. During open enrollment I check the drugs we take against the lists, a pain yes. You shouldn't need part D, but you may have to change plans. Also make sure your doctors and hospital are also in the plan if you change.

The paragraph below is from the Federal Emplyee's Retirement Blog.

"Secondly, you must decide on whether to sign up for the Original Medicare plan (Part A and B) or Medicare Advantage Part C that offers private sector Health Maintenance Organizations (HMOs) or Preferred Provider Organizations (PPOs) coverage. Part D, Medicare’s prescription drug benefit, requires an additional monthly premium and is unnecessary in most cases because our FEHB plans include a comprehensive prescription drug benefit."

And I should have done what YOU did, but was not taking this medication until early this year.

I have to continue my federal plan to provide coverage for my husband, so that's an issue, too.

See my complete explanation below.

Re: Medicare Part D quesion

Witchy Woman — Tue, 22 Mar 2016 11:44:02 GMT

Thanks to all who responded.

Clearly, I have some work to do to try to figure it out. I appreciate all the suggestions for doing so.

My Federal Employees Health Benefit plan DOES provide drug coverage. It is one of the better fee-for-service plans (GEHA), and I have been enrolled in the Standard option for many years. I am a healthy person, so most years, I didn't meet the deductible. In the past, most drugs were completely covered, but that has obviously changed!

Additionally, my husband is covered under my plan as he is an independent builder. He is not yet eligible for Medicare.

My hope was that Part D would cover the cost of any drugs NOT fully covered under my health plan. That may not be the case.

Obviously, I have to do more investigating/question asking before making any decisions. I am currently paying a monthly premium for my Federal health plan, AND paying a quarterly Medicare premimum. Since I receive Federal retirement and NOT Social Security benefits, the Medicare premimum must be paid directly to them every 3 months.

It was something I didn't think much about until I started taking an expensive drug. Even if insurance covers 1/2, costs can add up quickly. There may not be an option, but I'll keep looking.

Re: Medicare Part D quesion

nomless — Tue, 22 Mar 2016 11:53:52 GMT

@CelticCrafter wrote:
Is it a requirement that you have to have Part D or is it an optional coverage?

You have to have a qualified prescription insurance plan. It does not need to be a Part D plan. "Qualified" means it meets the standards defined by the government.