The Definitive Guide to Medicare Part D Plans in Florida

Florida Medicare Part D, which is also referred to as the Medicare prescription drug benefit, is a plan that is offered by the United States Federal Government as a Medicare plan add on, which is used to subsidize the costs of participant’s prescription drug insurance premiums. Navigating Medicare supplements, Part D included, can be a complicated and confusing process. Continue reading for a list of frequently asked questions about Part D plans, as well as information that can help you determine if Medicare Part D Florida is right for you. And as always, if you are ready to receive a quote or would like to talk to a representative, give our office a call or fill out the quote form on our web page.

When did Medicare Part D start?
Medicare was created in 1965, and since then, the role of prescription medications for maintaining health and treating illness has grown significantly. Extensive research and development have led to new, and increasingly expensive medications. The group most likely to be negatively affected by rising drug prices are senior citizens. To address this, the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) was signed into law by President George W. Bush in December of 2003. This change to Medicare drug plans also affected Medicare Part C and was officially in practice in January of 2006. Coverage is now available to help ease the burden of prescription drugs and is available through insurance companies and HMOs. Enrollment in a Part D plan is entirely voluntary.

Who is Medicare Part D eligible?
Enrollment in a Medicare Part D plan is voluntary, and may or may not be something you want to add to your existing Medicare plan. To be eligible for a Part D add on, you must be eligible for Medicare itself. You are eligible for Medicare if:

-Those aged 65 or older who are valid United States citizens and who have paid into the Medicare system via their payroll taxes (or who have a spouse who paid into the system)
-Those who are under 65, but who have been diagnosed with end-stage renal disease (irreversible kidney failure)
-Those who have been diagnosed with Lou Gehrig’s Disease (ALS)
-Those who receive benefits from Social Security Disability because of a disability or an illness, although they will have a 2-year waiting period before benefits begin.

How does Medicare Part D work with other insurance?
How Medicare Part D works with other insurance types will vary depending on the type of other insurance you carry. It is always best to talk to an insurance professional before adding a Part D plan to ensure that the changes are compatible. What Medicare Part D covers, however, may be consistent with some insurance types and beneficial to your financial situation. Here is a brief overview of how Part D plans work with common insurance types.

Employee or Union Health Care Coverage – If you try to add a Part D plan to your employee or union health care coverage, it is probably that you and any family who are covered by the employee or union coverage will lose that coverage.

COBRA – If you are currently enrolled in a COBRA policy, you can switch to a Part D plan upon the cessation of the COBRA insurance

Medicaid – If you receive Medicaid benefits, it is necessary to join a Medicare plan to receive coverage for prescription drugs.

Supplemental Security Income Benefits – If you are receiving Medicaid from the state, you will need to enroll in a Medicare plan, but will automatically qualify for what is known as “extra help.”

State Pharmaceutical Assistance Program – Although each state sets its own rules regarding how Medicare and State Pharmaceutical Assistance Programs work together if you have State Pharmaceutical Assistance it is likely that with Medicare you will receive extra help.

Long-Term Care Facility – Because Medicare Part D plans contract with long-term care facilities, you will have the option of choosing a plan that is in contract with your facility.

HUD Housing Assistance – If you receive assistance with housing though a HUD program and join a Medicare Part D plan, you are not at risk of losing the housing assistance, although the monetary value of your assistance may decrease.

Food Stamps – Food stamps and Medicare can coincide, although the amount of food stamps benefits may decrease as prescription drug assistance increases.

It is important to always read plan information to ensure that your insurance types are compatible with a Part D plan. If you are unsure, an insurance professional will be able to help you review your plans and choose a course of action that is best for your needs.

Where to sign up for Medicare Part D?
There are many options as to where to get Medicare Part D coverage in Florida. Many reputable companies offer the prescription drug coverage to Medicare recipients, although all have different areas of strength and weakness. The best way to determine which provider is right for you, and the easiest way to know all options have been researched is to enlist the services of a independent insurance agency such as ours. We will compare all the available options and help you to enroll in a Medicare Part D Florida plan that best fits your prescription drug coverage needs.

When is Medicare Part D Open Enrollment?
Medicare part d enrollment period happens annually and is commonly referred to as open enrollment. This annual event falls on October 15th until December 7th of every year.

If you are signing up for a Pard D plan for the first time, it is important to note that the open enrollment period was designed for those who are already enrolled in a plan to change their plan should they desire. If you are approaching your 65th birthday, the easiest way to figure out your enrollment period is to contact your insurance professionals, as the dates are unique to your birthday and your current insurance situation.

Additionally, if you have been waiting for a letter from the government announcing that it is time for you to enroll in a Part D plan, that message will never come. It is your responsibility to ensure that you are prepared for enrollment periods.

Who offers Medicare Part D plans in Florida?
Medicare Part D plans Florida are provided by several highly respected insurance providers. For a complete list of options and more information about their unique coverage options, begin your quest for insurance coverage by contacting our office today.

How much does Medicare Part D cost?
There are many factors that play into what does Medicare Part D cost per month, and the monthly cost will be different for each individual. Some of the factors that play into what does Medicare Part D cost include:

-Your age
-Your relative health
-When you signed up
-What company you go through
-The companies formularies and drug tiers
-Any other insurance you are carrying
-How long you or a spouse paid into the Medicare system via your payroll taxes (those who paid less than ten years of taxes will face higher premiums than those who paid more than ten years of taxes)

In 2016, the average premium paid monthly by those enrolled in a Medicare Part D prescription drug coverage plan was $34.10. While it seems intuitive to choose a plan that comes with a low monthly premium, it is a good rule of thumb to only choose a low premium plan if the yearly costs are also small. This is best determined by figuring the monthly cost of your prescribed medications and whether or not you will hit the donut hole (and the cost of your prescriptions while in the donut hole).

Allow us to work with you to determine what does Medicare Part D cost, and review what companies offer the best cost for your financial situation today. We can also help you discover what additional coverage or help you are eligible for, should your situation require additional help.

What is the Medicare Donut Hole?
The Donut Hole is a common name given to the coverage gap that exists in Part D plans. This is a period in which an individual has met their initial coverage limit (limit on what your plan will cover annually) and the beginning of your catastrophic-coverage limit (the highest amount you can be expected to pay out of pocket). The monetary costs of these limits and the rules that apply to them vary between plans. Becuase many with Part D plans will hit the donut hole each year, review these limits with your insurance professional to assure that the financial cost to you during this period is financially feasible or to ask about adding insurance that will assist with this gap.

Which Medicare Part D Plan is best?
No one Medicare Part D plan is best, as each offers different formularies (lists of covered medications) and pricing tiers. What works for you may not work for your best friend and vice versa. For this reason, it is best to thoroughly review the terms, conditions, benefits, and formularies of each available plan before deciding, ensuring that you are purchasing a plan that fits both your prescription drug needs, meshes with current insurance (if necessary) and also fits within the confines of your budget. Because so many companies offer Part D coverage, it is beneficial to enlist the assistance of a trusted insurance professional.

How to change your Medicare Part D plan?
Unless your situation calls for a special enrollment period, you are able to change your plan once a year, between the dates October 15th – December 7th. To avoid penalties, any changes should be made within these dates. There are, however special enrollment periods that occur if:

-You have moved outside of the confines of your current coverage area
-You have moved, are still in the confines, but your new address has better options
-You had been living out of the country but have returned to live in the United States
-You are moving into/moving out of a nursing facility
-You have been released from jail
-New opportunities for better coverage have just become available
-Your current plan is no longer available

There are many other reasons for special enrollment periods availability. If you find yourself in a situation where you need to or would like to switch, you are always welcome to call our office and discuss whether or not you qualify for one of these periods.

Why use our agency for your Medicare Part D needs?
Our company is an independent insurance agency. What this means for you is that we are not contracted to one particular insurance provider, but instead can shop the competition, representing the needs of you, our client, rather than trying to force your needs into one provider’s plan. Being able to shop the competition impartially also allows for price comparison. Pricing among companies can vary drastically, even between plans that offer the same benefits. Taking the time to look into various provider’s pricing can end up saving you a lot of money in the long run.
Another reason it pays to shop with our company is that researching different providers and their plans can be time-consuming, especially if you are not used to dealing with insurance lingo and nuances. When you tell us what your insurance requirements are, we can do the shopping for you, saving you time and energy.

If you have further questions, such as how to apply for Medicare Part D Florida or have concerns about Florida Medicare Part D cost, we are more than happy to discuss these questions and more. Please never hesitate to stop by, call and talk to a representative, or directly request a quote on our website. We look forward to assisting you with your Medicare Part D needs.