Senior Educators: Drug Insurance

Medicare Part D, or prescription drug insurance, is the most recent addition to the Medicare program. Prior to Part D, many Medicare recipients had to pay all of their prescription drug costs out of pocket. With Part D, the average Medicare recipient saves about $1,200 a year.

By law, Part D is quite comprehensive and covers nearly all types of prescription drugs. The drugs a particular plan covers differ by drug formulary, or list of covered medications. However, Part D works a bit differently than other types of insurance, and is a bit confusing for most of us. Part D initially helps pay for some drugs, but then stops helping pay for drugs when one reaches the coverage gap, or 'donut hole.' Fortunately, there is a safety net, and all Part D plans provide excellent catastrophic coverage.

What are my Part D options?

Medicare Part D, unlike Original Medicare, is administered solely through private insurance companies who are under contract with Medicare. There are two types of Part D plans: integrated Medicare Advantage Part D plans and standalone Prescription Drug Plans. In most places there are more than 50 Part D plans to choose from, so it’s important to shop around or have us shop around for you.

What are important considerations when I choose a Part D plan?

The most important decision in choosing the right Part D plan for your needs is whether to purchase and integrated or standalone Part D plan. Many people think drugs are the most expensive part of healthcare, when in fact doctors and hospitals are the most costly healthcare services. According to Medicare, the average beneficiary saves about $1,000 a year in an Medicare Advantage Part D plan versus original Medicare and a standalone Part D plan.

There are four important things to consider when choosing a Part D plan:

are you comfortable with the company;
what is the premium;
does the plan cover your drugs or reasonable substitutions; and
does the plan cover drugs in the donut hole?

Where does Senior Educators Insurance Services fit in?

Many people like help deciding which plan is a good choice for them. Plans vary widely from company to company and from place to place, and when comparing plans between companies it’s important to compare the fine print—not just the premiums. That’s what Senior Educators Insurance Services was created for—to provide free, unbiased assistance to Medicare recipients to help them choose appropriate coverage. To request help now, please fill out the short informational form here so a licensed representative can be well informed about your healthcare preferences. Or simply give us a call at 1-800-505-8575 and speak with a trained and licensed representative now!

If you prefer to do the research by yourself, we’ve created a number of tools to help you do so. First, we have created the Senior Educators Insurance Services’ Top 10 Tips for Navigating Medicare, which captures a very high-level perspective on what to consider based on our years of experience. Second, we have created a plan comparison engine that shows you a list of the plans available in your area. To access that tool, enter your zip code on the side of this page and click the “Find Plans” button. We hope that if you find a plan through our tools, you’ll enroll through our organization, as it’s how we can afford to provide excellent, unbiased information and help.