KBenefits Insurance Services
Medicare Part D

Medicare Part D Prescription

Open Enrollment For Part D Prescription :   October 15 -  December 7th
Plans will start or renew January 1st. 

Shop your Part D coverage at Medicare.gov.

  1. Go to Medicare.gov.
  2. Click:  "Find Plans"
  3. Click:  "Continue without logging in"
  4. Select:  "Drug Plan (part D)"
  5. Enter:   "Zip Code"
  6. Select  "I don't get help from any of these programs"
  7. Select  "Yes"
  8. Select  "both"


2)  Enter your prescriptions:

  1. Enter your prescriptions
  2. Select your pharmacy

 

3)  View Results:

  • View all your Part D Carrier plan options.
  • Plans are listed lowest total cost:  "yearly premium + out of pocket expenses". 


You can print/save the report for your records.

Part D Prescription Plans

Stage 1:  Rx Deductible:
The amount you must pay for health care or prescriptions, before Original Medicare, your Medicare drug plan, your Medicare Health Plan, or your other insurance begins to pay.  For example, in Original Medicare, you pay a new deductible for each benefit period for Part A, and each year for Part B. These amounts can change every year.

 

Stage 2:  Initial Rx Coverage Level:
Once you have met your yearly deductible, and until you reach the plan's out-of-pocket maximum, you pay a copayment (a set amount you pay) or coinsurance (a percentage of the total cost) for each covered drug.

Stage 3:  Rx Coverage Gap:
Starting January 1, 2011, if you reach the coverage gap (also called the "donut hole") in your Medicare prescription drug coverage, you will get approximately a 50% discount on covered brand drugs. Medicare has also increased its coverage of generic drugs for beneficiaries in the coverage gap so that beginning in 2011 you will pay less for generic drugs as well. The drugs eligible for the brand discount or the additional generic savings may change based on the information we have available.

 

Stage 4:  Catastrophic Rx Coverage:

Once you reach your plan's out-of-pocket limit during the coverage gap, you automatically get "catastrophic coverage."  Catastrophic coverage assures that once you have spent up to your plan's out-of-pocket limit for covered drugs, you only pay a small coinsurance amount or a copayment for the rest of the year.

Part D - Star Ratings - 2022
AARP Medicare Rx Preferred:          3.5 out of 5
AARP Medicare Rx  Saver Plus:       3.5 out of 5
AARP Medicare Rx  Walgreens:       3.5 out of 5

 

Horizon Blue Rx saver               3 out of 5
Horizon Blue Rx standard        3 out of 5
Horizon Blue Rx enhanced      3 out of 5

Humana Walmart Value:          3 out of 5
Humana Preferred Rx:              3 out of 5
Humana Basic Rx:                      3 out of 5

Mutual of Omaha Value:   (too new for rating)
Mutual of Omaha Plus:      (too new for rating)

SilverScripts Choice:        4 out of 5
SilverScripts Plus:             4 out of 5
SilverScripts SmartRx:     4 out of 5

Wellcare Wellness:            3.5 out of 5
Wellcare Value:                  3.5 out of 5
Wellcare Classic:               3.5 out of 5

Medicare's Star Rating System measures the performance of Medicare Advantage and Part D plans.  The Rating System scores how well plans perform in several categories:  quality of care and customer service.  Ratings range from 1.0 to 5.0 stars, with five being the highest and one being the lowest.  You can use the overall star rating to compare performance among several different plans but it's most important to make sure the plan you choose has your prescriptions covered their their formulary list.   Medicare reviews plan performance yearly and releases new star ratings each fall.

Part D plans (PDP) are rated on how well they perform in four different categories:
   *  Drug plan customer service
   *  Member complaints
  *   Problems getting services
  *   Choosing to leave the plan
   *  Member experience with the drug plan
   *  Drug pricing and patient safety

Medicare Advantage plans (MAPD) (Part C) are rated on how well they perform in five different categories:
    *  Staying healthy: screenings, tests, and vaccines
    *  Managing chronic (long-term) conditions
    *  Plan responsiveness and care
    *  Member complaints

    *  Problems getting services
    *  Choosing to leave the plan
    *  Health plan customer service

Do I Need To Enroll in Part D Rx?  Yes.  Here’s a few reasons why:
But "I don’t take medications" (or) "I take inexpensive medications".

 

  1. #1 reason - premiums are as low as $7 per month.
    Why take the risk and not be covered?

     
  2. Penalty per month for life! 
    1% per month extra premium penalty for not having credible coverage.

     
  3. No drug coverage.  You pay 100% of the cost.
     
  4. Things can change. When need coverage, you can’t enroll in a Part D Rx plan until January 1st.  So it can be many months of paying 100% for meds and accruing penalty for life.
     
  5. Your current medications may be affordable because you are using insurance. 
    Check Rx prices without insurance at Goodrx.com to get an idea of the cost of your medications.

Contact us for questions, plan options and free enrollment assistance.

Christopher S. Kudryk
chris@kbenefits.com
732-333-1976


KBenefits Insurance Services
Health - Life - Medicare

Christopher S. Kudryk
Insurance Specialist
chris@kbenefits.com
732-333-1976

KBenefits Insurance Services provides insurance solutions for small business owners and individuals in New Jersey, New York, Pennsylvannia & Florida..

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