Drug Coverage

Medicare Part D Coverage

When Original Medicare started in 1965, the American government saw no need for prescription drug coverage, which is why your Medicare card only has Part A (Hospital) and Part B (Medical). It wasn’t until much later that the government realized prescription drug coverage was a necessity. Unfortunately, it would have been too much to change Medicare A and B, as well as Medicare Supplement Plans like F or G, so they created Medicare Part D, a stand-alone prescription drug plan. As a result of this plan, more people could afford their prescription medication, leading to a lower death rate among Americans. Every Medicare Part D plan has a formulary, or a list of covered prescription drugs. If you buy a Part D plan during the 2019 enrollment period, you will only pay a portion of the cost of these drugs, and your plan will cover the remaining balance. Not all drugs are included, so it is essential to review all of the Plan D options before buying any policy.

An essential provision of Medicare Part D plans is the “donut hole,” or coverage gap. Before 2011, after you have received more than the coverage limit of $2,960 in benefits, you were responsible for 100 percent of your prescription costs. After that time, a “Donut Hole Discount” could be applied wherein your plan and the prescription manufacturer pick up some of the cost, even after you meet the coverage limit. Beginning in 2019, your Part D plan will pay 35 percent of the costs, and the drug manufacturer will pay 55 percent, adding up to 90 percent coverage. If you go any further and exceed $4,700 in out-of-pocket expenses, you are protected by the Catastrophic Coverage provision and will be responsible for a 5 percent copay of the formulary drug’s retail price. It should be understood that this provision only applies to prescription medications covered under your plan’s drug list; otherwise you will still have to pay 100 percent of the drug’s cost. There are also benefits and extra help available for those with low incomes, so many of these terms may be flexible depending on the enrollment of each prescription plan.

There are no Medicare Medigap Supplement plans that include prescription drug coverage, but there are about 25 different Part D drug plans available through Medicare. You can pick the Part D plan that is best suited for you and apply it to your new or existing Medigap plan during the enrollment period. The monthly premiums are very reasonable and can be deducted automatically from your social security check.

Upon enrolling in a Medigap plan, you will be contacted by one of our Certified Medicare Part D plan Specialists, who will discuss your prescription needs and help you enter into an appropriate plan. Our plan finders are Medicare, Medigap, Dental, and Part D specialists trained to show you the best options available and work with you to ensure your specific medications are on the plan’s list and your plan is financially viable.

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“By the way, as I said, my husband went in for a knee replacement, had a stroke and was there 3 weeks and then needed a nursing home/rehab place.

The one recommended to us was fully covered by Mutual of Omaha. Had we chosen the Medicare Advantage plan, he wouldn’t have been able to go there. They won’t pay. the hospital person helping me was relieved to here we had straight Medicare and a supplemental.”

-Chris, Happy Customer

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"Well THANK YOU SWEET GIRL, this morning I need some good news to start my day off. All of you have been so easy to work with and helpful, I cannot imagine doing this on my own. You have saved my insanity and I appreciate all that you and Arlene have done for me!!! Your Friend Forever!"

-Audrey (Patty) S, Happy Customer

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Matt, I want to say a GREAT BIG THANK YOU for all your assistance in helping me make my decision on my Medicare supplement. You were so willing to take the time and explain my options. I have already recommended you to others and will continue to do so. You are the best.

-Carlene, Happy Customer

Testimonials

Jim, Just a quick note to say Thank You for your help in selecting a Medicare supplement plan. Your simple as 1,2,3 explanation clarified for me how Medicare works and helped me make a decision after a month or so of sorting thru a myriad of paperwork and plans that I could not figure out on my own.

-Jed K, Happy Customer

Testimonials

I would like to thank you for helping me with my Medicare Supplement Plan. It can be a very confusing time trying to sort out everything. Mr. Fred Lewis is truly a great asset to your company. He explained everything in a very logical and concise manner. He had a lot of patience for all of the questions that I asked. He always was able to answer them and make me feel comfortable about everything. When Fred told me that somebody else would contact me about the drug plan, that is exactly what happened. Everything that Fred told me would be sent to me, was. I really appreciated the time and knowledge that was put into helping me. I now feel much better knowing that everything has been taken care of and handled.
I would recommend your company to anyone who is interested in getting a Medicare Supplement Plan. Thank you again for all of your help and for Mr. Fred Lewis.

-Margaret M, Happy Customer

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