Medicare Part D is a voluntary prescription drug benefit. The drug plans are offered by insurance companies and other private companies approved by Medicare. People can choose to join a Medicare drug plan that meets their needs based on coverage, cost, convenience, and customer service.
There are many plans to choose from. Drug plans may vary in what prescription drugs are covered, how much someone has to pay, and which pharmacies can be used. All drug plans will have to provide at least a minimum standard level of coverage, which Medicare will set. However, some plans might offer more coverage and additional drugs for a higher monthly premium. When a person with Medicare joins a drug plan, it is important for them to choose one that meets their prescription drug needs.
The plans can change premiums, co-payments and formularies (list of drugs they cover) every year so reviewing plans during the election period is important.
There are two types of Medicare Drug Plans:
- Medicare Prescription Drug Plan (PDP). These plans add drug coverage to the Original Medicare Plan and some other types of Medicare plans. In 2012, there are 30 plans available in Louisiana.
- Medicare Advantage Plan (MA-PD). This is an HMO or PPO and other Medicare health plan that includes prescription drug coverage. You will get all of your Medicare coverage (Part A and B), including prescription drugs (Part D) through these plans.
All Medicare drug plans must offer at least the standard level of coverage as the original Medicare. Plans can be flexible in their benefit design and offer different or enhanced benefits. Their benefits and costs may change from year to year.
Medicare Prescription Drug Coverage offers:
- prescription drug coverage for everyone with Medicare regardless of income and resources, health status, or current prescription expenses;
- both brand name and generic prescription drugs at participating pharmacies convenient to beneficiaries;
- protection for people who have very high drug costs or from unexpected prescription drug bills in the future.
Medicare drug plans will cover generic and brand name drugs. To be covered by Medicare, a drug must be available only by prescription, approved by the Food and Drug Administration, used and sold in the United States and used for a medically accepted indication.
Each plan will have a “formulary” that tells you which drugs are covered by the plan. Plans may require prior authorizations, step therapy and quantity limits.
Enrollment into Medicare Part D is not automatic.
You may sign up for Part D when you first become eligible for Medicare A and/or B which is three months before the month you turn age 65 until three months after you turn age 65. This is called your “initial enrollment period” or IEP. If you are eligible to enroll in this drug coverage and you do not, you will have to pay a penalty if you join later on, unless you are eligible for extra help with costs. If you have other drug coverage now, you may not have to pay the penalty. If your current coverage is considered “creditable” or at least as good as or better than the Medicare Drug coverage you may not be subject to a penalty. You will need to consult the company offering your current coverage.
If you receive Medicare due to a disability, you can join from three months before to three months after your 25th month of cash disability payments.
The list below contains the highest rated Medicare Part D prescription drug plans in the state of Louisiana. It is for informational purposes only and some listings may be inaccurate or missing. The list was provided by the Centers for Medicare and Medicaid Services (CMS), but due to the variance in plans based on county, city, and region, some options may not be available in your location.