Medicare Part D was created in 2003 to help seniors with the increasing burden of prescription drug costs. There are 205 Med Part D plans currently in the US and some are national while others are more regional. All of these plans have differences and will be advantageous to some senior while not to others. Each plan talks separately with each pharmaceutical company and each plan has their own marketing teams and goals.

Every year seniors should choose the plan that best fits their current situation the best. Married couples will many times have different plans because they have different needs (drugs) from the plan. An example is that a major cholesterol medication that can be either $50 per month on one plan while over $200 on another (almost $2,000 per year difference). 

Components of a Medicare part D Plan

1. Deductibles – How much you must spend before coverage starts.
2. Copays – How much each branded and generic costs after the deductible.
3. Donut Hole (coverage gap….see golden nugget) 
4. Monthly Premium $ – The amount that Medicare will take out monthly from your social security check.
5. Catastrophic Coverage – A fixed $ amount and then lower copays occur.

Action Step: Each year there is an open enrollment period between Oct 15th to Dec 7th and you can switch your Medicare part D plan. You can also switch (Special Enrollment Period) if certain things change in your life (long list) but you need to call Medicare at 1-800-Medicare to get approval.

Golden Nugget: Donut Hole – You will hear many seniors discuss donut holes with regard to their Med part D and they are not talking pastries. The donut whole refers to a dollar range that the plan won’t pay any for any drug costs (example would be from $2,800 to $4,300. So once the patient hits $2,800 in drug costs for the year, the patient is on the hook for the next $1,500.