Medicare Prescription Plans - Things to Consider

Medicare Prescription Plans - Things to Consider

The Medicare prescription drug plans program, also known as Medicare Part D is offered to anyone eligible for Medicare and who have joined a Medicare Part A or Part B program.

A variety of prescription drug plans are available, depending on need.

  • Medicare Advantage Plans
  • Medicare prescription drug plans

A Medicare Advantage plan is similar to Health Maintenance Organization or Preferred Provider Organization plans in that they offer health plans that incorporate a Medicare prescription drug coverage plan in their policies. Individuals who receive Medicare Advantage also receive Medicare Part A and B coverage.

Individuals receiving Medicare Part D are required to pay monthly premiums and meet yearly deductibles. Different types of drug plans will have different monthly premiums and deductibles, so compare carefully before making a choice.

Individuals should sign up for Medicare prescription plans three months before or after their 65th birthday, or when they're first eligible for Medicare benefits. Individuals who don't sign up for prescription or Part D benefits may need to wait for specific enrollment periods for their next opportunity to sign up for such benefits.

medicare prescription plans

What Does Medicare Prescription Plans Offer?

Medicare prescription plans offers a type of insurance that helps to pay for brand name as well as generic prescriptions. Pharmacies must participate in the Medicare prescription drug program for consumers to benefit from such coverage.

The type of Medicare drug prescription program available to seniors depends on location. In order to research various options, log on to the Medicare.gov website Medicare Plan Finder to determine what's available in specific geographical locations depending on current drug needs.

Plans vary by type and may include:

  • Medicare health plans without drug coverage
  • Medicare health plans with drug coverage
  • Prescription drug plans with original Medicare

Some plans have annual drug deductibles and drug co-pays. Some may have out-of-pocket spending limits, some drug coverage restrictions and monthly premiums. Benefits may also depend on the pharmacy or location where prescriptions are filled. For example, a senior with a Humana Health Insurance policy who has her prescription drugs filled at a Wal-Mart may spend approximately $200 on an Ambien prescription every year. Monthly premiums for drugs may range around $15.00, with an annual drug deductible of roughly $300. Drug co co-pay costs may range between $2.00 and $5.00, or 20 to 35%.

medicare prescription plans

That same individual taking the antihypertensive drug Propranolol may enjoy the same monthly premiums, deductibles, and co-pays but may spend approximately $500 annually on the drug.

Consumers should not hesitate to estimate annual health and drug costs when comparing overall plan ratings, benefits and expenses. Some of the most common drug prescription plans are offered through AARP, and major national health insurance companies popular in certain regions. For example, United Health, Humana and Rocky Mountain Medical Insurance are popular health plans offered in Colorado, while Blue Cross/Blue Shield and CareMore are popular in California.

Medicare Prescription Card Coverage

Beginning in 2011, Medicare package programs will offer people who want to enroll a variety of plans and options in regard to their drug and prescription needs. Research the variety of programs available when looking for coverage, quality of care, and deductibles.

One of the most looked forward to benefits of new changes in the Medicare card program is the avoidance of the dreaded "dough-nut hole" which occurs on a yearly basis, and doesn't offer coverage of medications for 2 to 3 months out of the year.

Starting in 2011, Medicare recipients will only pay half the price of their non-covered prescription medications during this period. Medicare supplement benefits may offer a cap set at approximately $2,840.

On the downside, Medicare Part D Medicare premiums for many seniors is expected to rise, again focusing on the importance of seniors and their family members to carefully research coverage options before enrolling in a Medicare prescription card program.

Medicare and Medicaid Page


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