Medicare Part D

 


Medicare Part D is the prescription drug benefit offered through the federal government’s Medicare program. The table below summarizes Medicare Parts A-D, with additional information about Part D following.

Coverage Covers Cost
Medicare Part A • Inpatient hospital stay
• Skilled nursing facility
• Home health care
• Hospice care
• Automatic eligibility if paid into Social Security
• No cost, no premium
• Deductible determined annually by Centers for Medicare and Medicaid Services (CMS)
Medicare Part B • Outpatient physician care
• Outpatient medical services
• Enrollment optional (although late enrollment penalty applies to most who delay)
• Participant pays premiums; amount varies by income
Medicare Part C (Medicare Advantage plans) • Medical and prescription drug services that traditional Medicare Parts A, B & D would otherwise cover • Enrollment optional
• Participant pays premiums
Medicare Part D • Prescription drugs (generic and brand name) • Enrollment optional (although late enrollment penalty applies to most who delay)
• Participant pays premiums; amount varies by income

 

Medicare Part D and You

Important: If you are eligible for Medicare but currently in a HealthFlex plan, you have prescription drug coverage through HealthFlex so you don’t need Medicare Part D while in HealthFlex.

  • Participants currently in a HealthFlex Medicare companion plan receive prescription drug coverage through the HealthFlex plan—not Medicare Part D—until December 31, 2014.
  • Effective January 1, 2015, the HealthFlex Medicare companion plan will be terminated. Participants should contact their plan sponsors for more details about coverage in 2015 and beyond.

If you are in a Medicare supplemental plan through OneExchange (formerly Extend Health) or another insurance exchange or carrier (not HealthFlex), you can purchase prescription drug coverage through either a Medicare Advantage plan (provides medical and drug coverage) or a Medicare Part D plan (supplements Medicare Parts A and B).

 



Resources

Medicare website

OneExchange (Medicare supplementary coverage)

Notice about HealthFlex and Medicare Part D

Health Team 1-800-851-2201 (option 2).

Medicare Part D—General Information

The federal government’s Centers for Medicare and Medicaid Services (CMS) mails a Medicare and You Handbook to Medicare participants each fall. Participants can opt to receive this Medicare handbook electronically instead. This handbook contains general information about all parts of Medicare, including Part D.

Visit the federal government’s Medicare website at www.medicare.gov to learn more about Medicare Part D coverage.

 
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