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Medicare Part D Basics

Important Things to Know about Medicare Part D

  1. It is voluntary, except for people who have both Medicaid and Medicare.
  2. Private insurance companies, not Medicare, offer the prescription plans. However, Medicare has approved of every company that has a plan.
  3. There are two ways of getting prescription drug coverage:  a stand alone plan (Part D) or a Medicare Advantage Plan with prescription benefits.  Plan costs vary depending on where you live and the plan you choose.
  4. Your yearly income and the amount of assets you have (not including the home you live in or your car) determine how much of the Part D costs Medicare will pay.
  5. If your income is low enough and you have very few assets, Medicare will give you "extra help" in paying for Part D. This can mean paying for part or all of your premium costs and paying a larger share of the medication costs than it does for people who have higher incomes.
  6. The doughnut hole occurs when Medicare stops paying for part of your drug costs and you pay all of these yourself.  People who are getting “extra help” will never get to the doughnut hole.
  7. Most states have many, many plans to choose from, making it difficult to make a decision.  All plans have to offer what Medicare calls a basic package, but some companies will offer more than one plan.
  8. You should pick a plan carefully.  If you need help, you can use a plan finder from the web or you call to find a free counselor in your state.
  9. Make sure you understand your medications before you pick a plan.  If you need to try to reduce these costs, check out these tips for talking to your doctor.  

Medicare Part D Resources

The official Medicare web site.

Website of the Social Security Administration.  Apply here for Part D extra help.


Questions and answers to help explain Medicare.


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