Medicare Part D Explained (2022) 

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Medicare Part D Explained
How Medicare part D works. This is the prescription drug portion of my Medicare Explained video series which includes my videos titled Medicare Explained, Medicare Supplement Plans Explained, Medicare Advantage Plans Explained and How To Sign-Up for Medicare. You will find all those free educational videos, plus dozens more when you subscribe to my channel. Or, you can just type in #MedigapSeminars in your RU-vid or Google search bar.
Understanding the Medicare Part D Prescription Drug plan is important because it is one of the areas of Medicare where you, the consumer can make some of the most expensive mistakes in Medicare. I am going to help you avoid those mistakes in this video.
There are four different ways you can be prescribed a medication. How your medication is prescribed and administered will determine which part of Medicare is responsible for payment.
First, you can be prescribed medication when you are an inpatient in a hospital.
Second, you can be prescribed medication that is administered by a medical professional at a medical facility.
Third is a concept called Brown Bagging and White Bagging prescriptions.
The fourth way to be prescribed medication is when your doctor writes a script and you pick up that prescription at a pharmacy or via mail order and then self-administer the prescription. This could be a pill, a self-injectable pen, an ointment an inhaler and so on. You pick up the prescription and administer it yourself. Prescriptions of this nature are covered under your Medicare Part D prescription drug plan.
Part D Plan Characteristics
The first thing you need to know about Medicare Part D prescription drug plans is that all Medicare Part D plans end on December 31 of each and every year. These are one-year, calendar year plans. Whenever you get a plan your commitment to the insurance company and the benefits they promised in the policy are just until December 31.
The second thing to understand about Medicare Part D plans is that every plan is different. They are the exact opposite of a Medicare supplement plan. As you may already know depending on where you are in your research, the benefits of a Medicare supplement plan are standardized to be identical from one insurance company to another and can never change. It is not that way with Part D prescription drug plans.
Medicare Part D plans are regulated to meet certain minimum requirements. For example, they all must cover a minimum of two drugs from every category. That means at least two high blood pressure medications and at least two statins for cholesterol and so on. In addition, they must cover all or substantially all the available prescriptions from six protected classes. The protected classes are immunosuppressants, antidepressants, antipsychotics, anticonvulsants, antiretrovirals and antineoplastics, which are medications used treat cancer and more commonly referred to as a chemotherapy or anticancer prescriptions. (antineoplastics)
Enrollment Periods
Next, we are going to cover enrollment periods.
Understanding the enrollment period is critically important because you cannot just enroll in a Medicare Part D prescription drug plan whenever you want. Missing an enrollment period is one of the most common mistakes made with Medicare Part D. This is because many people are focused on their Medicare supplement and don’t realize that the Medicare supplement and Medicare Part D enrollment periods are completely different.
Let’s take a closer look and hopefully make some sense out of these rules.
It is easiest to understand enrollment periods for Medicare Part D prescription Drug plans when you categorize them.
First there is an Initial Enrollment Period. This is your first enrollment period when you are first eligible for Medicare. For most of us that is the period when we are just turning 65.
A second group of enrollment periods are Annual Enrollment Periods. These happen every year, year-in and year out. They are based on a calendar year period.
Last, but not least are Special Enrollment Periods. A Special Enrollment period is triggered by an event. It can be an event you initiated or an event that was forced on you and is involuntary. That creates a Special Enrollment Period.
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