Medicare Part D
If you receive Medicare, you are eligible for Medicare Part D. You can be on Part A only or Part A and B. It does not matter what your income is or how many assets you may have. There are 2 types of Medicare D plans. One is added to your original Medicare plan. The other plan is a Medicare Health plan that covers both health care and prescription coverage.
The Standard Medicare Part D coverage is:
Deductible: $265
Premium: Starting at $15 and up depending on level of coverage.
Co payment: 25% of drug cost
Coverage gap: Coverage gap [sometimes called the “donut hole”] at $2400 in total drug cost until you spend $3850 out-of-pocket. You will spend no more than $3051.25 while in the donut hole. Once you’ve reached your plan’s out of pocket limit, then you will have catastrophic coverage. This means you only pay a small co pay like 5% of the drug cost for the rest of the year.
Private Insurance companies work with Medicare to provide these drug plans. Coverage will vary according to the plan. They are required to cover both generic and brand name drugs. Their formularies may be different. The cost of the plan will vary according to level of coverage. The above standard coverage is the minimum amount of coverage the insurance company may offer.
Medicare recipients who have low income and limited resources may qualify for extra help with their Medicare Part D costs. Depending on your income you may be able to get help paying for your premiums, annual deductible, and co pays. In most cases, there is no gap in coverage either. If in addition to Medicare, you are on Medicaid, receive SSI, or your state covers your Medicare premium, you are automatically eligible for extra help and do not need to apply for it.
To qualify for extra help, the 2007 income guidelines are $15,315 gross for a single person and $20,535 gross for a couple. In addition assets must be below $11,710 for a single person and 23,410 for a married couple.
For more information, click the link below:
http://www.accesstobenefits.org
Click on “Organizational Edition”
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