To get Medicare prescription drug coverage, you must join a plan run by an insurance company or other private company approved by Medicare. Each plan can vary in cost and specific drugs covered.There are two ways to get Medicare prescription drug coverage:
- Medicare Prescription Drug Plans. These plans (sometimes called “PDPs”) add drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private Fee-for-Service (PFFS) Plans, and Medicare Medical Savings Account (MSA) Plans.
- Medicare Advantage Plans (like an HMO or PPO) or other Medicare health plans that offer Medicare prescription drug coverage. You get all of your Part A and Part B coverage, and prescription drug coverage (Part D), through these plans. Medicare Advantage Plans with prescription drug coverage are sometimes called “MA-PDs.” You must have Part A and Part B to join a Medicare Advantage Plan.
In either case, you must live in the county of the Medicare drug plan you want to join.
When you join a Medicare drug plan, you will have to provide your Medicare number and the date your Part A and/or Part B coverage started. This information is on your Medicare card.
Note: Medicare drug plans aren’t allowed to call you to enroll you in a plan. Don’t give your personal information to anyone who calls you to enroll in a plan.
Most drug plans charge a monthly fee for Part D coverage that varies by plan. You pay this in addition to the Part B premium. If you’re in a Medicare Advantage Plan (like an HMO or PPO) or a Medicare Cost Plan that includes Medicare prescription drug coverage, the monthly premium may include an amount for prescription drug coverage.
Note: Contact your drug plan (not Social Security) if you want your premium deducted from your monthly Social Security payment. If you want to stop premium deductions and get billed directly, contact your drug plan.
What you pay for Part D coverage could be higher based on your income. This includes Part D coverage you get from a Medicare Prescription Drug Plan, a Medicare Advantage Plan, a Medicare Cost Plan, or employer group Medicare Advantage Plan that includes Medicare prescription drug coverage. If your income is above a certain limit, you will pay an extra amount in addition to your plan premium. Usually, the extra amount will be deducted from your Social Security check.
Most Medicare drug plans have a coverage gap (also called the “donut hole”). This means that there is 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. Once you enter the coverage gap, you get a 50 percent discount on covered brand name drugs and pay 86 percent of the plan’s cost for covered generic drugs until you reach the end of the coverage gap. Not everyone will enter the coverage gap. The following items all count toward you getting out of the coverage gap:
- Your yearly deductible, coinsurance, and copayments
- The discount you get on brand-name drugs in the coverage gap
- What you pay in the coverage gap
Some plans offer additional coverage during the gap, like for generic drugs, but they may charge a higher monthly premium. Check with the plan first to see if your drugs would be covered during the gap.
In addition to the 50 percent discount on covered brand-name prescription drugs, there will be increasing savings for you in the coverage gap each year until the gap closes in 2020.
The list below contains the highest rated Medicare Part D prescription drug plans in the state of New Hampshire. 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.