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Ashford Insurance

Medicare Prescription Drug Plans in Tarrant County, TX

Prescription Drug Plans Made Easy

Medicare Prescription Drug Plans in Tarrant County, TX

Medicare Part D is a voluntary program that provides prescription drug coverage for people enrolled in Medicare. It is not part of Original Medicare (Medicare Parts A and B), which does not cover prescription drugs.

There are a few ways to get prescription drug coverage through Medicare Part D:

  • Stand-alone Medicare Part D Prescription Drug Plan: This type of plan can be used in tandem with Original Medicare.
  • Medicare Advantage Plan with Prescription Drug Coverage: This type of plan combines Medicare Part A, Part B, and prescription drug coverage into one plan.
  • Medicaid Prescription Drug Coverage: If you are eligible for Medicaid, you may also be eligible for Medicaid prescription drug coverage.
  • Employer or Retiree Coverage: If you are still working or are retired from a job that offered health insurance, you may be eligible for prescription drug coverage through your employer or retiree plan.

Choosing a Medicare Part D Plan

When choosing a Medicare Part D plan, it is important to consider the following factors:

  • Cost: The monthly premium, deductible, and copays will vary from plan to plan.
  • Drug Coverage: Make sure the plan covers the medications you need. You can view a plan’s drug list to see which medications are covered.
  • Formulary: The formulary is a list of drugs that are covered by the plan. Plans may have different tiers of drugs, with higher copays for drugs in higher tiers.
  • Network: Make sure the plan has a network of pharmacies that are convenient for you.
  • Extra Help: If you have low income, you may be eligible for Extra Help to help pay for your Medicare Part D costs.

Enrolling in a Medicare Part D Plan

You can enroll in a Medicare Part D plan during the Medicare Open Enrollment Period (October 15 – December 7) each year. You can also enroll in a plan outside of Open Enrollment if you have a qualifying event, such as moving to a new area, losing your job, or becoming eligible for Extra Help.

To learn more about Medicare Part D, visit the Medicare website.

Extra Help

The federal government offers Extra Help with paying for your Medicare Part D costs. To qualify for Extra Help, you must have low income and limited resources. You can apply for Extra Help at any time by contacting Social Security.

Drug List

A drug list, sometimes called a formulary, is a list of drugs that are covered by a Medicare Part D plan. The drug list can change from year to year. Plans may add or remove drugs from their drug list each year. Changes may also be made during the year, for example, if a drug is taken off the market. Your plan will let you know if a change affects a drug you are taking.

Tiered Drug List

Many Medicare Part D plans have a tiered drug list where drugs are divided into groups based on cost. In general, drugs on low tiers cost you less than drugs on high tiers. Plans may charge a deductible for certain drug tiers and not for others, or the deductible amount may be different depending on the tier.

Requirements and Limitations

There are rules for some prescription drugs that limit how and when a plan will cover them. These are called requirements or limitations. If you don’t follow these rules or don’t get permission from the plan saying you don’t have to (called an exception), you may have to pay the full cost of the drug out of your own pocket.

I hope this information is helpful. Please let me know if you have any other questions.