People With Medicare
You may want to consider these things when making a decision about drug coverage:
Should you sign up for Medicare Prescription Drug Coverage?
- Assess your current situation. Think about the health insurance and prescription drug coverage you have now. Decide if it is as good as the Medicare Prescription Drug Coverage.
- If you have health insurance now and are married, your husband or wife’s drug insurance may change if you join a Medicare Prescription Drug Plan. This is especially true if you got your plan through the job you have now or through an old job. Find out what these changes would be—and if changes in his or her insurance would change your drug coverage.
- Also, if you have health insurance from a current or former employer, even if the Medicare Prescription Drug Coverage is a better deal for you, you may not be able to just drop the drug coverage under your current plan. So if you signed up for the Medicare drug coverage you would lose your health-care coverage through your current plan. So get as much information as you can from your current plan and consider your decision carefully.
- Think about how signing up for Medicare Prescription Drug Coverage would help you—and how it might not help.
- Understand that the Medicare Prescription Drug Coverage is insurance. If your health changes and you need more drugs in the future, this insurance will help pay for your drugs and protect you from very high drug costs.
- Decide when to join. If you have not yet joined a plan, you will pay higher premiums every month when you do join. You will pay this penalty unless the coverage you have now is as good as the Medicare Prescription Drug Coverage. If you would like to join a Medicare drug plan, consider joining during the next available enrollment period. The annual Open Enrollment Period runs from October 15 to December 7. This way, you will pay a smaller penalty.
- Find out if you qualify and apply for Extra Help paying for Medicare Prescription Drug Coverage. If you make less than $17,235 ($23,265 for a couple), you may be able to pay much less for your drugs. If you qualify for the Extra Help with costs, you can join anytime, without paying a penalty.
If so, which plan should you choose?
- You will want to narrow down your choices. Look for plans that cover all or most of your drugs for a lower cost and that let you to use a pharmacy near you.
- Fill out the Medications Worksheet (This file is in PDF format). Be sure to spell each drug correctly. If you spell a drug wrong, you may have trouble finding out if it is covered and how much it will cost.
- When you have finished the Medications Worksheet, go to the Medicare.gov Plan Finder. Look at the worksheet and type in the information about your drugs. Enter the name of the drugstore you like to use.
- With the help of the Medicare.gov Plan Finder, narrow your choices to two to four plans. Look for plans with the lowest “Estimated Annual Costs.”
- Plans with higher “Estimated Annual Costs” may not give you better coverage. For example, a plan may cost more because it does not cover the drugs you take. You would not get a discount for drugs that the plan doesn’t cover.
- If you qualify for Extra Help with costs, the Medicare.gov Plan Finder’s “Personalized Search” will show you what your drugs will cost. It’s important to get approved for Extra Help with costs. That way, you can find out exactly how much you will have to pay for your drugs.
- Call the two to four plans that look the best to find out more about them.
- Ask the plans if they have any special rules or limits for the drugs you take.
- Ask the plans how you can get your drugs if you travel or are away from home. Can you get your drugs sent to you if you go on a long trip?
- Ask for a copy of each plan’s drug list (formulary) and other information about how the plan works.
- You can find out more with the Medicare.gov Plan Finder. It will tell you if a plan covers your drugs and if the plan has any special rules or limits you need to know to get your drugs.
If you have trouble deciding which plan to choose, talk about it with someone you know and trust – a family member, social worker, financial advisor, or your doctor.
When you are ready, you can use the Medicare.gov website below to join a plan.
The material on the Medicare.gov site may make more sense if you read this information first:
Find and compare specific plans on the Medicare site. If you decide to join a plan, enroll when you are ready.
Find out if you qualify for Extra Help with Costs