Texas Medicare Part D - Prescription Drug Coverage 

Medicare has several moving parts, changing constantly and the prescription drug program approved by the government is no different. Known as Medicare Part D is a program enacted back in 2003 to allow seniors to receive coverage to help offset their prescription drugs. It’s a great plan, provided you have selected the correct plan and changes are being made almost yearly to tweak the program in order to make it better. 

Simply put, private insurance companies approved by Medicare offer drug coverage for a small monthly premium that can be deducted directly form your Social Security check. There are upwards of 30 plans being offered and the key is to find the one plan that best will handle your situation based on your current drug usage. Choosing the correct plan can be done using the Medicare website and following a few simple steps. 

You become eligible for Part D when you turn 65 in most cases and if you choose not to enroll at that time it works just like Texas Medicare Part B there will be a monthly premium penalty your will pay so it’s a good idea to just bite the bullet and enroll. It’s fairly cheap with the lowest cost plan costing about $15 a month and you are allowed to move from plan to plan each year to find one that better fits your needs.

  Make Changes Yearly During Your Enrollment Period to Insure Proper Coverage 

I know that when you hear the words changing plans fear and confusion sets in but it’s really not all that difficult. The Medicare website is somewhat user friendly and the site is set up to allow you to enter your current drug usage to better figure out which plan will deliver the lowest cost on prescriptions for the year. Signing up is easy by either calling the company the Medicare website says is the best, or let us handle it. Medicare also will terminate your old plan when you sign up for a new one. Prices range from $15.10 to $108 a month. I doubt you will ever find the need for the $108 plan. 

 What is this Doughnut Hole I Hear About?

Ok, so what’s wrong with the plan? Well, first off there is a goofy thing called the doughnut hole, most seniors have heard someone talking about this. So what is it? In 2013 once you and the Part D drug plan have spent $2,970 on copays, deductibles and premiums you fall into the hole of no coverage until such time as you have spent $4,750 then your plan kicks in again and pays most of your additional drug cost with you generally only paying a small co payment. Congress is working hard to close this crazy hole and this year you will pay 47.5% on brand name drugs and 79% of the cost on generic drugs while inside the doughnut hole, that helps somewhat. Medicare is closing the doughnut hole by phasing in changes and by 2020 the gap will be for the most part closed. 

Some plans also have a yearly deductible, not all but several have one. The yearly deductible is up to $325 and generally after that you will only pay either a co payment or a small percentage foe your drugs, again up to that doughnut hole. Most pharmacies accept the coverage so regardless of where you live, be it Arlington, Dallas, or Galveston you will find plenty of options available. 

Our suggestion is to purchase a Part D plan during the overall process of selecting a Texas Medicare Supplement plan and always do this by working with a qualified independent broker. We help seniors across the state daily select both their Texas Medicare Part D and MediGap coverage at the same time, its so much easier that way.

Some Medicare Advantage plans include your prescription drug coverage (Part D) in their benefit offerings eliminating the need to purchase a stand alone drug card.