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.
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.
Most Prescription Drug Plans have a coverage gap called a donut hole. This means there's a temporary limit on what the drug plan will cover for drugs. The coverage gap begins after you and your drug plan have spent a certain amount for covered drugs. For 2020, you're in the coverage gap once you and your plan have spent $5,100 on covered drugs. People with Medicare who get Extra Help paying Part D costs won’t enter the coverage gap.
Once you reach the coverage gap in 2020, you'll pay 25% of the plan's cost for covered brand-name prescription drugs. You get these savings if you buy your prescriptions at a pharmacy or order them through the mail. The discount will come off of the price that your plans have set with the pharmacy for that specific drug.
Although you'll only pay 25% of the price for the brand-name drug in 2020, 95% - what you pay plus 50% manufacturer discount payment - of the price will count as out-of-pocket costs which will help you get out of the coverage gap.
In 2020, the drug company will cover 50% of the cost, Medicare will pay 25% of the price for generic drugs during the coverage gap. You will pay the remaining 25% of the price. The coverage for generic drugs works differently from the discount for brand-name drugs. For generic drugs, only the amount you pay will count toward getting you out of the coverage gap.
It pays to review your Part D coverage every year, especially if you have started taking new drugs. You have 3 options to get assistance with your drug plan options:
You may qualify fore extra help if:
It never hurts to try if you think you are close to qualifying. You can apply for extra help HERE.
Download Medicare's instructions on applying for the Extra Help program.