medicare prescription drug...
TRANSCRIPT
Thorley Wealth Management, Inc.Elizabeth Thorley, MS, CFP®, CLU®, AIF®, AEP®CEO & President1478 Marsh RoadPittsford, NY 14534585-512-8453 x205Fax: [email protected]
Medicare Prescription Drug Coverage
September 28, 2017
If you're covered by Medicare, here's some welcomenews--Medicare drug coverage can help you handlethe rising cost of prescriptions. If you're covered byOriginal Medicare, some Medicare Cost Plans,Medicare Private Fee-For-Service Plans, or MedicareMedical Savings Account Plans, you can sign up for aMedicare Prescription Drug Plan (Part D) offered inyour area by a private company or insurer that hasbeen approved by Medicare.
Although prescription drug plans vary, all provide astandard amount of coverage set by Medicare. Everyplan offers a broad choice of brand name and genericdrugs at local pharmacies or through the mail.However, some plans cover more drugs or offer awider selection of pharmacies (for a higher premium)than others, so you'll want to choose the plan thatbest meets your needs and budget.
Note: Most Medicare Advantage (Part C) plans (suchas HMOs or PPOs) also offer prescription drugcoverage.
How much will it cost?What you'll pay for Medicare drug coverage dependson which plan you choose. But here's a look at howthe cost of Medicare drug coverage for a standardplan is generally structured. All figures are for 2017.
A monthly premium: Most plans charge a monthlypremium. Premiums vary, but average $34. (Source:Centers for Medicare & Medicaid Services.) This is inaddition to the premium you pay for Medicare Part B.You can have the premium deducted from your SocialSecurity check, or you can pay your Medicare drugplan company directly.
An annual deductible: Plans may require you tosatisfy an annual deductible of up to $400.Deductibles vary widely, so make sure you comparedeductibles when choosing a plan.
A share of your prescription costs: Once you'vesatisfied the annual deductible, if any, you'll generallyneed to pay 25% of your prescription costs and yourMedicare drug plan will pay 75% of your costs until
they total $3,700. After that, there's a coverage gap(also called the "donut hole"); you'll need to pay 100%of your prescription costs while you're in the donuthole. (Some plans offer coverage for this gap.)However, once your prescription costs for the yeartotal $7,425, your Medicare drug plan will generallycover 95% of any further prescription costs. For therest of the year, you'll pay either a coinsuranceamount (e.g., 5% of the prescription cost) or a smallcopayment for each prescription, whichever isgreater.
Note: In 2017, if you have spending in the coveragegap, you'll receive a 60% discount on coveredbrand-name drugs, and a 49% discount on coveredgeneric drugs.
Again, keep in mind that all figures are for 2017only--costs and limits may change each year, andvary among plans.
Totalprescriptioncosts in 2017
What you pay What Medicarepays
$0 to $400 You paydeductible of$400 (someplans may offerlowerdeductibles)
Medicare paysnothing untildeductible issatisfied
$400 to $3,700 You pay 25% ofcosts
Medicare pays75% of costs
$3,700 to$7,425
You pay 100%of costs
Medicare paysnothing
Over $7,425 You pay 5% ofcosts or smallcopayment
Medicare pays95% of costs
What if you can't afford coverage?Extra help with Medicare drug plan costs is availableto people who have limited income and resources.Medicare will pay all or most of the drug plan costs of
You should compare thedetails of each planavailable in your areabefore choosing one.You can get personalizedplan information at theMedicare website,medicare.gov, or bycalling a Medicarecounselor at1-800-MEDICARE.
Page 1 of 2, see disclaimer on final page
Prepared by Broadridge Investor Communication Solutions, Inc. Copyright 2017
Securities and advisory services offered through Commonwealth Financial Network member www.FINRA.org/www.SIPC.org , a RegisteredInvestment Adviser. Fixed insurance products and services offered through CES Insurance Agency. This material has been provided for generalinformational purposes only and does not constitute either tax or legal advice. Investors should consult a tax or legal professional regarding theirindividual situations.
people who qualify for help. If you haven't alreadyreceived a letter telling you that you haveautomatically qualified for help, you can apply onlineat the Social Security website or at your localMedicaid office.
When can you join?Individuals new to Medicare have seven months toenroll in a drug plan (three months before, the monthof, and three months after becoming eligible forMedicare). Current Medicare beneficiaries cangenerally enroll in a drug plan or change drug plansduring the annual election period that occurs betweenOctober 15 and December 7 of each year, and theirMedicare prescription drug coverage will becomeeffective on January 1 of the following year. If youqualify for special help, you can enroll in a drug planat anytime during the year. Certain other events mayqualify you for a Special Enrollment Period outside ofthe annual election period when you can enroll in aplan or switch plans.
If you already have Medicare drug coverage,remember to review your plan each fall to make sureit still meets your needs. Before the start of the annualelection period, you should receive a notice from yourcurrent plan letting you know of any important planmodifications or additional plan options. Unless youdecide to make a change, you'll automatically bere-enrolled in the same drug plan for the upcomingyear.
Do you have to join?No. The Medicare prescription drug benefit isvoluntary. However, when deciding whether or not toenroll, keep in mind that if you don't join when you'refirst eligible, but decide to join in a future year, you'llpay a premium penalty that will permanently increasethe cost of your coverage. There's an exception tothis premium penalty, though, if the reason you didn'tjoin sooner was because you already had creditable
prescription drug coverage, defined as coveragethrough another source (such as employer healthplan) that was at least as good as the coverageavailable through Medicare. If you have coveragethrough another source, talk to your benefitsadministrator, insurer, or plan before making changesto your coverage. If you drop your coverage, you maynot be able to get it back.
What happens after you join?Once you join a plan, you'll receive a prescriptiondrug card and detailed information about the plan. Inorder to receive drug coverage, you'll generally haveto fill your prescription at a pharmacy that is in yourdrug plan's network or through a mail-order service inthat network. When you fill a prescription, show thecard to the pharmacist (or provide the card numberthrough the mail) even if you haven't satisfied yourannual deductible, so that your purchase countstoward the deductible and benefit limits.
What if you have questions?If you have questions about the Medicare prescriptiondrug benefit, you can get help by calling1-800-MEDICARE (1-800-633-4227) or by visiting theMedicare website at medicare.gov. Look forinformation in the mail from Medicare and the SocialSecurity Administration (SSA), including a copy of thisyear's "Medicare and You" publication that will giveyou details about the prescription drug plans availablein your area.
Choosing a MedicarePrescription Drug Plan
• Start by making a list ofall the prescription drugsyou currently take andthe price you pay forthem to see how muchyou're spending onprescription drugs.
• Next, compare plans atthe Medicare website.Does each plan cover allof the drugs youcurrently take?
• What deductible andcopayments does eachplan require?
• What monthly premiumwill you pay?
• What pharmacies areincluded in each plan'snetwork?
• Finally, ask for help.Personalized counselingis available through yourState Health InsuranceAssistance Program, oryou can call a Medicarecustomer representativeat 1-800-MEDICARE.
Page 2 of 2