Medicare

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Medical Prescription

Medicare Part D is an optional coverage that will help pay for your prescriptions, when enrolled. This plan has different choices, which you can choose the right plan that will cover your prescription requirements. Medicare Part D does have a program that will allow people who qualify to get “extra” help to help cover the cost of Medicare Part D. 

At Senior Insurance Consultants we understand you need the best prescription coverage and will help you understand which plans cover which drugs, especially ones you might be currently taking. Some things to take into consideration are if you use generic medications, have expensive medications, or what medications are currently being taken.

Medicare Part D has a few different alternatives from choosing a deductible, co payment, or coinsurance. If you chose to have a deductible, then you will need to meet your deductible (out-of-pocket amount) before Medicare will kick in and pay for your prescriptions. They do offer different deductible amounts with $0 deductible being the lowest out-of-pocket cost. If you chose to have a co payment then your prescriptions will be a fixed price, make sure to check out what generic, preferred and non-preferred prices are as they are different for each category. If you chose coinsurance then your prescriptions will be a percentage of their price.

At Senior Insurance Consultants we are able to help you understand what tier you might need and help you understand which choice might be better from deductibles to coinsurance. It is important to bring what medications you are currently taking when we meet.

Gap Coverage

When your prescriptions total over $3820 for the year, Medicare Part D no longer covers your medications unless your prescription expenses goes over $5100 out-of-pocket or when you reach $7654 total drug cost, this is considered catastrophic coverage. Gap coverage will help you be covered if your prescriptions go over $3820 for the year, this is an important coverage if you will spend more than $3820 on prescriptions for the year. The gap coverage currently covers 37% on generic and 75% on brand name prescriptions. If you make it to catastrophic coverage, which means you have spent over $5100 out-of-pocket or $7654 total drug expense, then you will be covered at 95% or more for your prescriptions for the rest of the year and there is no longer a cap amount.
You might be wondering how they get to those amounts. Each month that you purchase prescription medications you will receive a report with your current out-of-pocket expenses. There are two parts to what does and doesn’t count towards your out-of-expense costs. First is called your “true” out-of-pocket expense and this counts toward your yearly amounts. This is considered any money that you have paid for drugs that are covered including copay or deductibles, what is also included in that amount are the price that the manufacture pays for the prescription. Don’t worry if you get help from others you will still get the credit for the amount paid. The second part that does not count towards your yearly amount are if you purchase things like over the counter, employee coverage, or other drugs that are not covered. 
We understand that getting the right prescription coverage is important and at Senior Insurance Consultants we are here to help you understand all your options.

Call to schedule an appointment

Call Senior Insurance Consultants today for more information on our available insurance policies 480-383-9349.