When you enroll in Medicare Part B plan, it is the best time to sign up for Part D as well.

It is important to qualify for Part D at the earliest opportunity. Signing up late would result in an additional amount on your premium. The insurer will compute for the number of month that you are late. Therefore, sign up for this coverage even though you are not taking prescription drugs at this time.


You may avoid the penalty charges if you have equivalent drug coverage from another source, for example, retiree plan. It is also referred to as creditable coverage. Ask your plan administrator if your plan can be considered as an equivalent coverage.


How Much Is Medicare Part D


The rates vary but you will pay $32 per month, on the average. Basically, you pay less out-of-pocket if you opt for a plan that has a higher premium.


In 2015, there was a  $320 maximum allowed deductible for Part D. The charges are also dependent on the prescription drugs. They may charge according to co-insurance, which is a certain percentage of the prescription cost. Other times, the charge is a flat-dollar co-pay.


Generally, the drugs are grouped into tiers. The prescription drugs on the bottom part of the tier have the most affordable amount.


3 Phases of Part D Coverage


Phase 1: Initial Coverage. Your own share of expenses is based on the cost of your prescriptions, the amount of prescriptions you take, and if you have a deductible. On the average, you will pay 25% of the prescription drugs until you reach the amount of $2,960.


Phase 2: Donut Hole. Together with the Medicare drug plan, if the medications you spend reach $2,960, you will be in this donut hole phase. It is also known as the coverage gap. In this phase, your share for your generic drugs is 65%, and 45% of the brand-name drugs.


The Affordable Care Act has set a schedule for the termination of donut hole. It is estimated to be completely close in 2020.


Phase 3: Catastrophic Coverage. When your share reaches the amount of $4,700 both from the cost of generics and brand-name drugs, you are now in the period of catastrophic coverage. In this phase, you pay 5% of the medications up to the last month of the year.  


Medicare Part D is an important coverage. Ask an agent to explain the rules of this coverage much further to get the most out of it. At Dave Silver Insurance, we work hard in making sure that our clients are well-protected with policies that they can afford. To learn more about how we can help you, please contact our agency at (941) 907-2879 or Click Here to request a free quote.