You can sign up for Part D Prescription Drug Plans, which helps cover prescription drug costs, along with other components of Medicare starting three months before your 65th birthday.
It’s important to do this on time because there’s a permanent premium surcharge for enrolling more than three months after your 65th birthday if you don’t have equivalent drug coverage from another source, such as a retiree plan.
Let Us Help You With Your Enrollment
If you are already enrolled in a Part D “standalone” plan or a Medicare Advantage plan that incorporates drug coverage, you can switch plans during the open-enrollment period, which runs from Oct. 15 to Dec. 7 every year.
Making Part D Work
In 2022, you are facing higher out-of-pocket drug costs before you can qualify for catastrophic coverage. The out-of-pocket spending threshold will increase by $500, from $6,550 to $7,050 in 2021.
You will also face higher out-of-pocket costs in 2022 for the deductible and in the initial coverage phase before reaching the catastrophic coverage. The standard deductible is increasing from $445 in 2021 to $480 in 2022, while the initial coverage limit is increasing from $4,130 in 2021 to $4,430 in 2022.
For costs in the coverage gap phase, beneficiaries will pay 25% for both brand-name and generic drugs. Manufacturers provide a 70% discount on brands and plans pay the remaining 5% of costs for brand name drugs. Plans pay the remaining 75% of generic drug costs. For total drug costs above the catastrophic threshold, Medicare pays 80%, plans pay 15%, and enrollees pay either 5% of total drug costs or $3.95/$9.85 for each generic and brand-name drug, respectively.
Choosing A Plan
It pays to review your Part D coverage every year, especially if you have started taking new drugs.
- Start at Medicare.gov, where you can find the basics about the benefit and Part D plans. There’s a link to the Medicare Part D Plan Finder, which allows you to compare offerings and coverage options in your area and includes a helpful formulary finder that allows you to compare plans based on their coverage of your personalized list of drugs. It will even show you your monthly out-of-pocket drug cost for the year
Call us to help you understand your options.
Getting Financial Help
Individuals with annual incomes of less than $19,320 and financial resources of up to $14,790, or married couples with incomes of less than $26,130, might qualify for Extra Help from Medicare to pay their Part D premiums and out-of-pocket drug costs.
Additionally, read about the six ways to lower your drug costs on Medicare.gov.
*Disclaimer: This page has not been reviewed or endorsed by Medicare.gov or any member of the Centers for Medicare & Medicaid Services (CMS).