Medicare Plan Part D Coverage

On January 1, 2006 everyone with Medicare, regardless of income, health status, or prescription drug usage, had access to prescription drug coverage.

If you want to take advantage of the Medicare prescription drug coverage, there are several steps you should consider to help you make your decision.

The decision to get Medicare prescription drug coverage depends on how you pay for your prescription drugs now and how you get your Medicare coverage. Most people with Medicare pay for drugs and get their Medicare in one of five ways:

1. Original Medicare only, or Original Medicare and a Medigap (‘Supplement') Policy without drug coverage. The Medicare prescription drug coverage will cover half of the costs for you if you have this kind of coverage now. Enhanced options are available that provide more coverage.

2. Original Medicare and a Medigap (‘Supplement') Policy with drug coverage. The Medicare prescription drug coverage will generally provide much more comprehensive coverage at a lower cost.

3. Retiree or union coverage. In most cases, people with good retiree or union coverage can continue to get it, with new financial support from Medicare.

4. Medicare Advantage Plan (like an HMO or PPO) or other Medicare Health Plan, which already include drug coverage and other extra benefits.

5. Dual coverage from Medicare with Medicaid drug coverage. These people will automatically get comprehensive prescription drug coverage from Medicare.

If you decide that you want prescription drug coverage, you need to understand what matters most to you. There are a range of plan options available, so you can decide on the kind of coverage that works best for you.

There are two ways you can get your Medicare drug coverage. You can add drug coverage to the traditional Medicare plan through a "stand alone" prescription drug plan. Or you can get drug coverage and the rest of your Medicare coverage through a Medicare Advantage plan, like an HMO or PPO, that typically provides more benefits at a significantly lower cost through a network of doctors and hospitals. No matter what type of plan you choose, you can choose a plan that reflects what you want in terms of cost, coverage and convenience.

You need to consider cost and look at what you pay for the coverage, including premiums, deductible, and payments for your drugs.

You also need to look at the coverage and the benefits that are provided (like coverage in the "coverage gap" and other coverage enhancements), which drugs are covered and the rules (like prior authorization) for getting those drugs.

Another consideration is your convenience and find out which pharmacies are part of the plan and whether the plan has a mail-order option.

The Medicare Plan Part D prescription drug coverage can help you get the medications that you need while helping offset the expense of those drugs.