Community Chat

[Mmsfoxxie]

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

[151949]

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

[m2p]

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."

[Goodie2shoes]

@Moonchilde,  thanks for the information

[Nuttmeg]

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@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."

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

[CelticCrafter]

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

[Witchy Woman]

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@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.

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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!

[Witchy Woman]

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@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."

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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.

[Witchy Woman]

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. 

[nomless]

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@CelticCrafter wrote:

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

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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.