Standard Medicare Part D Benefits for 2018
To determine when a member moves from one stage into the next, the drug plan keeps track of the members TrOOP (True Out-of-Pocket) costs. Any money spent during the Deductible, Initial Coverage, and Coverage Gap stages count towards the TrOOP. The members monthly premium payment does not count toward the TrOOP.
Although you’ll only pay 35% of the brand-name drug price in 2018, 95% of the price you pay plus the 50% manufacturer discount payment will count as out-of-pocket costs. This will help you get out of the coverage gap.
The amount beneficiaries must pay while they are in the coverage gap decreases by a small percentage each year until 2020 when they will be responsible for only 25% of brand and generic drug costs.
Medicare Part D Income-Related Monthly Adjustment Amount (Part D IRMAA)
As of January 1st, 2011, you could pay more for your monthly Part D premium based on your income. In addition to the monthly payments to your Part D plan, you will have to pay an additional premium payments directly to Medicare if your annual income two years prior was over $85,000 if single or over $170,000 if you are married and filing jointly.
Buying Part D Prescription Drug Plans
PDP’s can only be purchased at certain times of the year. The most common are during the Annual Enrollment Period (AEP). This occurs from October 15th through December 7th. Another time is three months before the first day of the month in which you turn 65. Consult your SecureCare65 agent or medicare.gov for other periods of eligibility.
If you choose not to purchase a Part D plan when you are first eligible, there is a permanent premium penalty of 1% of the national standard premium for every month that you could have had Part D coverage or equivalent creditable coverage.
Many Medicare Advantage plans offer Part D coverage. These plans are known as MAPD’s. If you have a Medicare Advantage plan be sure to check if you have prescription drug coverage before you enroll in a Part D plan. If you already have coverage, you will be dis-enrolled from your Medicare Advantage Plan and returned to Original Medicare.
If you are currently taking medication, compare the different Prescription Drug Plans based on your specific needs.
Before making a final decision, SecureCare65 highly recommends speaking with one of our licensed agents. We can help determine your eligibility and needs.
