Medicare Part D Facts

Medicare Part D Facts

Here at Farm Bureau Health Plans we always want to point you in the right direction when it comes to your health care coverage. Although we do not offer a Part D prescription drug plan at this time, we think it’s important to provide the information you need to select a Part D plan that best suits your needs and budget. 

Does everybody need a Part D plan? 

Everybody does not need a Part D plan. Some people on Medicare don’t need a Part D plan because they already have drug coverage through a current or former employer.

Is everyone able to get a Part D plan?

Anyone who has Medicare Part A and/or Part B and lives in a plan’s service area may enroll in a Part D plan.

Why should I enroll in a Part D plan?

Although enrollment in a Part D plan is not required, even people who do not take any medications should consider joining a plan when they are initially eligible for Medicare. You may be charged a late enrollment penalty if you decide to join Part D at a later date unless you have had creditable coverage (coverage that pays as well as Part D) since you first became eligible for Medicare. 

How do I pick the Part D plan that’s best for me?

Each drug plan has their own formulary, or list of medications they cover. You’ll want to choose a plan that contains all your medications on their formulary. The Plan Finder tool on www.medicare.gov will help you identify plans that cover your medications. It will calculate which plan does so at the lowest annual cost. It will also provide information about quality ratings, drug restrictions, and whether or not your pharmacy has preferred pricing.

You will find step by step instructions below showing how to use the Plan Finder tool. If you are not comfortable using the Plan Finder tool on your own, call Medicare at 1-800-633-4227 or the State Health Insurance Assistance Program (SHIP) at 1-877-801-0044. 

How much does a Part D Plan cost? 

You’ll want to take three costs into consideration – premiums, deductibles and copays. The plan’s total cost is the total of 12 monthly premiums, the annual deductible, and 12 months of copays. 

-The 27 drug plans available in Tennessee in 2016 have premiums ranging from $18.40 to $117.20 per month. 
-Annual deductibles range from $0.00 to $360.00.
-Copay amounts depend on the drug’s level or “tier”.  Plans typically have four or five drug tiers. Tier 1 drugs are generic medications with the lowest copays. Brand name medications are found in higher tiers and have higher copays. The more Tier 1 drugs you take, the lower your copays. The Plan Finder tool will calculate copays for all your medications for all drug plans in TN.


What information do I need to do a Part D plan comparison?

You will need a list of all your medications along with the number of milligrams (mg) and the number of times a day you take each one. You will also need to identify your pharmacy and zip code.


How do I enroll in a Part D Plan?  

You can use the Plan Finder tool to enroll in a Part D plan. If you’d prefer, you can enroll by calling the plan or Medicare at 1-800-633-4227 or the State Health Insurance Assistance Program (SHIP) at 1-877-801-0044.  


How does the Part D late enrollment penalty work?

The penalty is based on the number of months you did not have, but could have had, prescription drug coverage. For example, if you were 12 months late signing up for Part D, your penalty would be 12 months x National Base Beneficiary Premium ($34.10) x 1%= $4.09. This amount would then be rounded to the nearest ten cents. In this case, you would pay $4.10 in addition to your drug plan premium every month. The penalty is recalculated whenever the National Base Beneficiary Premium changes and will continue for the rest of your life. 


Do I really need to do a plan comparison every year?

Yes. CMS allows drug plans to change their entire cost and benefit structure each year. Look for changes in which drugs are covered by the plan, drug restrictions, preferred pharmacy networks, premiums, annual deductibles and copayments. It is absolutely NOT safe to assume this year’s plan will work as well next year. There is no penalty to change from one plan to another.
 

What steps do I take to find the right Part D plan?

Go to www.medicare.gov 
Select “Find health & drug plans”

Medicare Plan Finder page

-Enter zip code in In General Search box

-Select “Find Plans”

Step 1 of 4: Enter Information page

-Select “Original Medicare”

-Select “I don’t get any Extra Help”

-Select “Continue to Plan Results”

Step 2 of 4: Enter Your Drugs

-Type the name of your drug

-Select “Find My Drug”

-Under Search Results, click “Add Drug” across from selected medication 

On pop up box, Select correct dosage, frequency and retail pharmacy on pop up box.  Note: Select “every 1 month” if you take one per day.  Also select retail pharmacy even if you do mail order.  You will be able to show 3 months at a time via mail order without checking these boxes later on in the process.

-Once your three selections are made on pop up box, select “Add drug and dosage”

-You will be returned to previous page. Record Drug List ID and Password Date

-Add balance of your medications

-Once list is complete, select “My Drug List is Complete” 

Step 3 of 4: Select Your Pharmacies

-Select at least one pharmacy; maximum of two pharmacies

-Select “Continue to Plan Results” 

Step 4 of 4: Refine Your Plan Results

-Check “Prescription Drug Plans (with Original Medicare)

-Select “Continue to Plan Results” 

Your Plan Results

-The first entry will be “Your Current Plan”.  This will show Original Medicare if you did a general (as opposed to a personalized) plan search. Go down to list of Prescription Drug Plans in section below.

-The first plan listed in this section is the plan with the Lowest Estimated Annual Retail Drug Cost.  This is the plan with the lowest total of 12 months of premiums, annual deductible and 12 months of copays/coinsurance.

Do not make your decision based on price alone. Review the Overall Star Rating, Drug Coverage and Restrictions, and Pharmacy Status associated with this plan. If you are not happy with anything you see, move down to the next plan on the list repeat this process.

You can examine each plan individually or compare up to three plans at a time by checking the box in front of the plan names and selecting the “Compare Plans” button.      

-For additional details on plan, double click on plan name. 

Your Plan Details

This screen shows additional details such as monthly copays for each medication, drug restrictions, mail order pricing and whether or not the individual is expected to enter the donut hole.

No further action is required if you choose to remain on the same drug plan for 2016. If you select a different plan for 2016, click on the “Enroll” button on either the “Your Plan Results” or the “Your Plan Details” screen.  Fill in the online application. Be sure to record the confirmation number once your application has been submitted.


For more information on Medicare Part D click here to review the Medicare and You 2016 book, which is the official U.S. Government Medicare Handbook.

 

Ready to Enroll?

Farm Bureau Health Plans is proud to offer quality coverage at an affordable cost.

Medicare Supplements Insured by TRH Health Insurance Company, Columbia, TN.
TRHH-POST-POLA-FL14-174; TRHH-POST-POLB-FL14-175; TRHH-POST-POLC-FL14-176; TRHH-POST-POLD-FL14-177; 
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