By Gloria Smith

Parts, plans, tiers – Oh my.

Do you feel like Dorothy and Toto, dealing with Medicare prescription choices?

I hope this helps.

Parts A and B covers in and out of hospital services. Most people add a prescription plan. There is a 1 percent (of $33) penalty if you don’t enroll in Part D unless you have creditable coverage elsewhere, such as VA, TRiCare, Employer Coverage.  The penalty is payable as long as you have a prescription plan.

Two options for Part D:
Enrollment in Part A or B is required for a standalone plan. You can also get prescription coverage through a Medicare Advantage Plan.

Medicine is assigned a category for payment called a tier. Each tier has a fee structure (co-payment or percentage). Plans usually include at least two medicines for most conditions. Each company decides which two medicines they cover.

What to do if I want to change?
Read the annual notice of change that is sent to you by Oct. 1. Confirm the coverage and cost for your medicine.  You make changes between Oct. 15 and Dec. 7.

What do you need to know about Prescription Medicine for 2017?

There are three categories of cost:
• Initial – Covers cost of medicine (your co-payment and plans payment) up to $3,700 including a deductible up to $400. Not all plans have deductible.
• Gap/Donut hole – $3,700 to $4,950
• Catastrophic – $4,700 and above


Ask Gloria Smith, Independent Insurance Broker, gloria@gloriadsmith.com, 520-568-6750 , Insurance and Consulting Services, LLC.

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