Lumaktaw sa pangunahing content

How much do I pay for Medicare Part D?



Monthly Premium
Most drug plans charge a monthly fee that varies by plan. You pay this in addition to the Part B premium. If you're in a Medicare Advantage Plan or a Medicare Cost Plan that includes Medicare prescription drug coverage, the monthly premium may include an amount for prescription drug coverage.

Contact your drug plan if you want your premium deducted from your monthly Social Security or RRB payment. If you want to stop premium deductions and get billed directly, contact your drug plan.

IMPORTANT!
If you have a higher income, you might pay more for your Part D coverage.
If your income is above a certain limit, you'll pay an extra amount in addition to your plan premium which is sometimes called Part D-IRMAA. You'll also have to pay this extra amount if you're in a Medicare Advantage Plan that includes drug coverage. 

Usually, the extra amount will be deducted from your Social Security check. If you get benefits from the Railroad Retirement Board (RRB), the extra amount will be deducted from your RRB check. If you're billed the amount by Medicare or the RRB, you must pay the extra amount to Medicare or RRB and not your plan. If you don't pay the extra amount, you could lose your Part D coverage. You may not be able to enroll in another plan right away and you may have to pay a late enrollment penalty for as long as you have Part D. 

Visit socialsecurity.gov or call Social Security at 1-800-772-1213, 
TTY users can call 1-800-325-0778. 


Yearly deductible
This is the amount you must pay before your drug plan begins to pay its share of your covered drugs. Some drug plans don't have a deductible.


Copayments or Coinsurance
These are the amounts you pay for your covered prescriptions after the deductible. You pay your share and your drug plan pays its share for covered drugs. If you pay coinsurance, these amounts may vary throughout the year due to changes in the drug's total cost. 


Catastrophic coverage
Once you've met your plan's out-of-pocket cost requirements for the year, you automatically get catastrophic coverage. With catastrophic coverage, you only pay a reduced coinsurance amount or copayment for covered drugs for the rest of the year.

Note: If you get Extra Help, you won't have some of these costs.
Visit Medicare.gov/plan-compare to get specific Medicare drug plan costs and call the plans you're interested in to get more details.


Part  D Late enrollment penalty
The late enrollment penalty is an amount that's permanently added to your Part D premium. You may owe a late enrollment penalty if, at any time after your Initial Enrollment Period is over, there's a period of 63 or more days in a row when you don't have Part D or other creditable prescription drug coverage. 


3 Ways to avoid paying a penalty:

  1. Join a Medicare drug plan when you're first eligible. Even if you don't take prescriptions now, you should consider joining a Medicare Prescription drug plan or a Medicare Advantage Plan that offers drug coverage to avoid a penalty. You may be able to find a plan that meets your needs with little to no monthly premiums.
  2. Enroll in a Medicare drug plan if you lose other creditable coverage. Creditable prescription drug coverage could include drug coverage from a current or former employer or union, TRICARE, Indian Health Service, the Department of Veterans Affairs, or individual health insurance coverage. Your plan must tell you each year if your drug coverage is creditable. If you go 63 days or more in a row without a Medicare drug plan or other creditable prescription drug coverage, you may have to pay a penalty if you join later.
  3. Keep records showing when you had creditable drug coverage, and tell your plan if they ask about it. You don't tell the plan about your creditable prescription drug coverage, you may have to pay a penalty for as long as you have Part D coverage.

How much more will I pay?

The cost of the late enrollment penalty depends on how long you didn't have creditable drug coverage. 

Currently, the late enrollment penalty is calculated by multiplying 1% of the national base beneficiary premium by the number of full, uncovered months that you were eligible but didn't join a Medicare drug plan and went without other creditable prescription drug coverage. The final amount is rounded to the nearest $.10 and added to your monthly premium. Since the national base beneficiary premium may increase each year, the penalty amount may also increase each year. After you join a Medicare drug plan, the plan will tell you if you owe a penalty and what your premium will be. 


Example: 
Mrs. Martin didn't join a drug plan when she was first eligible- by June 2017. She doesn't have prescription drug coverage from any other source. She joined the Medicare drug plan during November 2019, and her coverage began on January 1, 2020.

Since Mrs. Martin was without creditable prescription drug coverage from July 2017- December 2019, her penalty in 2020 is 30% of $32.74 ( the national base beneficiary premium for  2020), which is $9.82. The final amount is rounded to the nearest $.10, so she'll be charged $9.80 each month in addition to her plan's monthly premium in 2020. She'll continue to pay a penalty for as long as she has Part D coverage, and the amount may go up each year.

Calculation:
.30 (30% penalty) x $32.74 (2020 base beneficiary premium) = $9.82
$9.80 = Mrs. Martin's monthly late enrollment penalty for 2020


What if I don't agree with the penalty?

If you disagree with your penalty, you can ask for a review or reconsideration. Generally, you must request this review within 60 days from the date on the first letter you get stating you have to pay a late enrollment penalty. You'll need to fill out a reconsideration request form by the date listed in the letter. You can provide proof that supports your case, like information about previous creditable prescription drug coverage. If you need help, call your plan provider.






Mga etiketa:

Mga Komento

Mag-post ng isang Komento

Mga sikat na post sa blog na ito

Durable Medical Equipment and Medicare

Medicare   Part B  covers the D urable Medical Equipment (DME).   These are equipment that serves a medical purpose, able to withstand repeated use, and is appropriate for use in at home.  There are many important things to know about Medicare’s coverage for DME. Below are pieces of information that will help you know whether/how you are covered. Eligible equipment Medicare’s DME benefit does not cover all medical equipment.  Medicare only covers DME if your  provider  says it is  medically necessary for use in the home . You also must order your DME from suppliers who contract with  Original Medicare  or your  Medicare Advantage  Plan . However, Medicare Advantage Plans may have additional requirements you need to meet before your DME is covered. DME coverage Depending on what type of equipment you need, Medicare will require that you either rent or buy DME. There are also special rules when you need oxygen equipment...
Mag-post ng isang Komento
Magbasa nang higit pa

Medicare & group health plan after you retire

Will my group health plan still work after I retire? It would depend on the terms of your specific plan. Other employers might not offer any health coverage after your retirement and even if you can get one, it might have different rules and might not work the same way with Medicare. When you have retiree coverage from an employer or union, they usually manage this coverage. Employers aren't required to provide retiree coverage, and if they would, they can change benefits or premiums, or even cancel coverage.  They may offer coverage that limits how much it will pay. It might only provide a stop-loss coverage that starts paying your out-of-pocket costs only when they reach of coverage that's covered. What happens to my retiree coverage when I'm eligible for Medicare? When you become eligible for Medicare, you will need to have both Medicare Part A and Medicare Part B to get full benefits from your retiree coverage. If your former employer offers retiree...
Mag-post ng isang Komento
Magbasa nang higit pa

Medicare Part D Costs for 2020

Before 2006, Medicare did not cover prescription medications. There was a limited number of medications that were offered under Medicare Part Band,  and otherwise, you had to pay for your medications out of pocket. In 2003, everything had changed when President George W. Bush passed the Medicare Prescription Drug, Improvement, and Modernization Act (MMA). This is what we now know of as  Medicare Part D , an optional part of Medicare that provides prescription drug coverage. Part D plans are run by private insurance companies and not by the government. However, the federal government sets guidelines on what basic medications are covered and how much you can be charged.  A deductible is the amount of money you spend out of pocket before your prescription drug benefits begin. Your plan may or may not have a deductible. The maximum deductible a plan can charge for 2020 is set at $435. It has increased by  $20 from 2019...
Mag-post ng isang Komento
Magbasa nang higit pa