Monday, February 8, 2021

Part D

 What's Part D? Is it required?

Part D is drug coverage. Private insurance companies contract with the Federal government I order to offer Part D to the public. Like advantage plans, the premium and benefits are based on a local service area. This might mean a carrier could offer different Part D plans in different counties or states. Also, this is explains why the premiums vary from one service area to the next.

Part D coverage covers prescriptions written by Medicare approved doctors filled at standard pharmacies. This means Cannabis dispensaries, VA, Canadian or international pharmacies, or even maybe the "pharmacy" at your doctors office, which might be a small vending machine safe at the nurse's station, are not covered. Some medicines at the doctors office are covered by Part B, but that will be discussed in a different post.

Part D plans come in HMOs and PPOs. HMOs will have lower premiums and copays, but only certain pharmacies will accept them. This means if you are traveling the country in RV, either bring a 90 day supply or stick with a national chain like CVS or Walgreens. 

All Part D plans offer some kind of mail order and this will almost always be the best deal. Even insulins or other fragile medications are sent my mail. The prescriptions are almost always filled at a regional facility closest to your home and will arrive in 2 days or next day. 

Part D plans vary in monthly premium from $30 to $120. At the end of the day, our-of-pocket drug spend is very similar no matter what plan you get and all plans have to carry the same drug classes so the real difference is how you pay and what brands are covered. For example, a plan with a high premium will have little to no deductible and small to no copays, but you pay in the form of a high premium that might be over $1000/year. On the other hand, a plan with a small monthly premium would have a high deductible and copays, maybe $450 deductible and $10-$50 copay. So the premium is only $360 a year but your out of pocket with deductible could easily be $640, making it no cheaper than the higher premium plan. 

Part D plans have coverage tiers and levels of generic and brand names but I will have to discuss this details another time. Thanks for reading and please follow.

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Part D

 What's Part D? Is it required? Part D is drug coverage. Private insurance companies contract with the Federal government I order to off...