Medicare Part D: Prescription Drug Plans Questions

1. Does Mom keep her private insurance if she gets Medicaid?

   Your mother is now what's called a "dual-eligible" -- meaning she's enrolled in both Medicare and Medicaid. That changes the other insurance she needs.
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2. What are the 2009 figures for Medicare Part D prescription drug plan premiums, deductibles, co-payments, and coverage gaps?

   Every year, the premiums, deductibles, co-payments, and coverage gaps change for Medicare Part D prescription drug plans. Here are the figures for 2009:
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3. When Can I Join or Switch to a Medicare Part D Prescription Drug Plan?

   You can join a Medicare Part D prescription drug plan as soon as you first become eligible for Medicare Part A or enroll in Medicare Part B (either when you turn 65 or become eligible for Medicare because of a two-year, continuing period of Social Security disability benefits)...
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4. Should I Join a Medicare Part D Prescription Drug Plan if I Have Other Drug Coverage?

   Usually not, for two reasons: First, if your other drug plan covers all the prescription drugs you regularly take, enrolling in a Medicare Part D prescription drug plan would be a waste of money -- one plan or the other can pay for a single prescription, but not both...
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5. Should I Enroll in Medicare Part D?

   For someone who doesn't take regular prescription drugs, the answer is probably no -- especially if the premium, which averages $35 a month, is more than she typically spends on prescriptions. But she might still want to consider enrolling in a Medicare Part D plan if one is offered in her state for a very low ($5 a month or less) or no premium...
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6. How Does Someone Get Coverage for a Non Formulary Drug?

   If you have a prescription for a drug that isn't on your plan's formulary, there are several things you -- or a family member -- can do. First, ask your Part D plan for an exception, which -- if granted -- would mean that the plan will cover the drug...
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7. How do I find a Medicare Part D plan that covers nursing...

   Generally, the task of picking the right Medicare Part D prescription drug plan is the same whether someone is in a nursing home or not. That's because paying for the cost of a nursing home does not include prescription medications, which must be paid for separately...
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8. How do we get my mother onto Medicare part D?

   The good news is that your mother can sign up for any Medicare Part D prescription drug plan that's offered where she lives. To find out what plans are available, and to begin learning about their "formulary" list of drugs (to make sure that your mother's drugs are all covered by the plan she signs up...
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9. Do you need a prescription for a walker?

   No, you don't need a prescription for a walker, but I wouldn't recommend buying a walker on your own. An inappropriate or improperly used walker can actually contribute to a fall. It's also important to remember that some people should only use a walker with supervision. Also, people with dementia may always need reminding to use their walker...
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10. Do I need a Medicare Part D prescription plan if I have Blue Cross/Blue Shield work insurance?

    To encourage as many people as possible to sign up for a Medicare Part D prescription drug plan when they're first eligible for it (usually at age 65), Medicare imposes a financial penalty on those who don't sign up then. The penalty is a one percent per month increase in premiums for every month you delay in signing up...
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11. Do any Medigap policies include drug coverage, or must you also get a Part D supplement from another source?

    No Medigap policies sold to new enrollees today include any prescription drug coverage. That's because drug coverage through Medigap was replaced by the Medicare Part D prescription drug program , which went into effect January 1, 2006. [Before 2006, a few Medigap policies (in categories H, I and J) included some prescription drug coverage...
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12. Is there any "gap" plan we can buy to help cover what Medicare Part D isn't?

    There are at least two things you can do. The first is to try to find free or low-cost prescription drugs for the time your father is in the donut hole. There are a number of programs and tactics for seniors on Medicare to obtain free or low-cost medications; they are explained in the...
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13. I am 70 years old and retired collecting SS and under...

    The Medicare Part D prescription drug plan you mention is about average in terms of monthly premium -- about $35 per month. For many people, the premium cost is offset by the savings they get on their regular prescription drugs. But if you do not take regular prescription drugs, why should you pay this $420 a year...
    1 Expert Answer, 6 Community Answers

14. Can we reapply for Medicare C & D?

    Tell her not to panic -- she still has a lot of coverage, and some options to get more. First of all, even without her Medicare Part C plan, she still has hospital and skilled nursing facility coverage through Medicare Part A. Her Medicare Part A hospital and nursing facility coverage remained in effect...
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15. Which prescriptions will Medicare Part D cover?

    The specific prescription drugs a Medicare Part D plan covers depends entirely on the particular plan you enroll in (though every plan must cover at least one drug in all major therapeutic categories). Medicare's official Web site provides a simple tool called the Formulary Finder in which you just...
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16. Will being on my wife's insurance count as a Medigap policy?

    Let's start with your question about your wife's employer-sponsored group health insurance being the equivalent of a Medigap supplemental health insurance policy. Most employer-sponsored or union-sponsored group health plans coordinate with Medicare for employees or spouses age 65 or older...
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17. Do we need Medicare Part D?

    Many people who have other health insurance that covers some drug costs find that a Medicare Part D prescription drug plan doesn't save them money. But if your husband's prescription drugs cost you $1,200 out of pocket last year even with your other insurance coverage, then getting a Medicare Part D insurance plan is probably a good idea...
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18. Can you help explain Medicare Part D?

    Once your daughter's been receiving Social Security disability benefits for two years, she's eligible for full Medicare coverage, including a Part D prescription drug plan. The plans cost about $10 to $75 per month, depending on the plan's coverage and where your daughter lives. A few plans have no premium at all...
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19. If I go on Medicare, will my provided health coverage still be in effect?

    Many people in your situation are confused. That's because Medicare rules are complicated, and neither private insurance plans nor Medicare do a good job explaining these things to consumers. But you actually sound like you have things right.
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20. How can I get financial help for my parents who are at their donut hole with their prescriptions?

    One of several big concessions Congress made to the pharmaceutical industry when enacting the Medicare Part D prescription drug program's was the "donut hole" -- a period of no coverage when each of your parent's total drug expenses for the year reach $2,510 but out-of-pocket costs haven't yet reached $4,050...
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