Medicare Drug Plans: One Part of the Medicare Puzzle

Much like a puzzle, Medicare is a subject that may seem confusing until you familiarize yourself with the pieces and are able to conceptualize the bigger picture. One important puzzle piece is prescription drug coverage. Securing this will keep your costs down at the pharmacy and ensure you have affordable access to the medications you need for your health. Use the guide below as a reference before enrolling.    

IMPORTANT: The annual General Enrollment Period for Medicare ends March 31, 2022. You can apply online here or in person at a Social Security office. 

The basics

Medicare Part A and B are what’s known as original Medicare. The former is referred to as “hospital” insurance while the latter covers things like doctor’s visits, medical equipment, preventative services, and more. If you want drug coverage, you’ll need to apply for a separate Part D plan (just remember “D” for drugs!). Though, some Medicare Advantage Plans – which are offered by private companies – bundle your Part A, B, and D coverage. 

You ultimately decide whether you want drug coverage, as it isn’t a requirement for Part A or B members. As well, Medicare Advantage Plans without a Part D component are available. But if you want or need drug coverage, there are no additional eligibility requirements to apply. If you qualify for Medicare, you qualify for drug coverage – regardless of whether you take any medications currently. Visit Medicare.gov/plan-compare to review your options. 

Tips while shopping for a plan 

When it comes to Medicare drug coverage, you have options – a lot of them. Sometimes, the hardest part of finding coverage is filtering through all these options to determine the best one for you. Luckily, there are some tried-and-true ways to approach this task. 

1. Tailor coverage to any current needs

If you currently take prescription medications, it’s important to verify that the Medicare drug plan you’re applying to covers the same medication(s). You can do this by reviewing a plans formulary, which is just a list of all the prescription medications a plan covers. 

2. Be mindful of the ‘donut hole’

Unfortunately, this tip isn’t regarding delicious fried dough. Bummer, we know. Within the context of Medicare Part D, the donut hole refers to the plan’s coverage limit on prescription drugs. This differs from plan to plan, so be sure to thoroughly review how a plan is structured.   

3. Go generic 

Some Medicare drug plans operate under tiers that may charge you nothing for generic medications. Often, several manufacturers sell a generic version of a drug. Alternatively, only one manufacturer tests and sells a brand-name drug. Having multiple manufacturers creates more competition and therefore lowers the cost of generic options. You can expect these drugs to have the same active ingredients, quality, strength, and administration instructions as their brand-name counterparts. And for up to 85% less than the cost of brand-name drugs, it makes sense to consider this option.¹

Now that you have a better understanding of Medicare drug coverage, you can continue expanding your overall knowledge of Medicare with General Electric Credit Union’s (GECU) complimentary on-demand webinars. Watch Medicare 101 and Getting to Know Medicare at your convenience.