Southern Senior Care Blog

Medicare Prescription Drug plans (also known as Part-D, PDP) were first introduced in May 2006. Since that time, they have generated more confusion than any other enhancement to Medicare in the last twenty years.

It’s difficult to write an overview on this subject. There are so many facits that inevitably, whatever I discuss will probably not contain an answer to the one question you have. So, you will notice that there are many other postings in the Prescription Drug Plan blog category. You may find it useful to use the search tool on the right side of the blog screens. If all else fails, just use our Contact Form, send me a quick message and I’ll get back with you very quickly - usually the same day.

OK, so here’s my stab at an overview:

1. There are approximately 200 different Prescription Drug Plans (PDPs) avialable from about fifty different companies.
2. There is no “Best” plan for everyone. The best plan for YOU depends on exactly what prescriptions you are taking on a regular basis for most of the year
3. The average monthly premium for PDPs is around $30
4. Pretty much every PDP pays up to $2,410 of coverage per year. Then you enter what’s called the “donut hole.” more on that later.
5. Most PDPs have three “tiers” of drugs in their list of covered drugs. This list of covered drugs is called a “formulary.”
6. Your co-pays will generally be around $5 for tier 1 drugs, $20 for tier 2 drugs, and $60 for tier 3 drugs.
7. Some plans will continue to cover generic (tier 1) drugs after you exceed $2,410
8. You can only change PDPs during the “Annual Enrollment” period each year which starts November 15th and goes through December 31st.
9. You don’t have to get a PDP, but if you do not you will be subject to a late penalty which is 1% for every month you don’t join a plan once you are eligible.
10. You can almost always go to any drug store and use your PDP. Very few PDP’s have specific pharmacies you must use

Well, I think that is a good place to stop for an overview. Like I said there are lots of nuances to Medicare PDPs. Browse the other subjects in the Prescription Drugs categoy of the blogs for more information. As always, if you can’t find an answer use the Contact Form to ask us a question.