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Medicare Basics

Understanding your loved one's primary care insurance

Medicare Prescription Drug Coverage (also known as Part D)

  • There is no single Medicare drug plan.
  • They are run by private companies that have been approved by Medicare to offer prescription drug coverage.
  • Benefits and costs vary among sponsors and drug plans.
  • Medicare drug plans are not required to cover every prescription drug, but they must provide choices within each category of drugs.
  • Plans do not cover over-the-counter medicines.
  • Like other insurance, Part D plans have premiums, co-payments and/or coinsurance, and sometimes deductibles.
  • Costs will depend on what drugs you take and which plan you choose.

Paying for Medicare

Medicare Part D Extra Help Program

  • For people who have limited incomes and resources to pay for most of their Medicare Part D premiums, co-payments and deductibles.
  • Provides continuous drug coverage throughout the year.
  • Seniors who are enrolled in Medicaid, Supplemental Security Income (SSI) or a Medicare Savings program automatically get Extra Help with paying for Part D. Otherwise, seniors need to first apply for Extra Help and then enroll in a private Medicare approved prescription drug plan.

Medicare Savings Programs

  • These programs help pay out-of-pocket Medicare costs for people with Medicare who have limited incomes and resources.
  • Programs are known as the Qualified Medicare Beneficiary (QMB), the Specified Low-Income Medicare Beneficiary (SLMB) and the Qualifying Individuals (QI).

Medigap or Medicare Supplemental insurance

  • Sold by private companies, this coverage pays for some of the health care services and supplies not covered by Original Medicare such as your share of doctor and hospital services.

Also of interest: Americans speak out on the future of Medicare. »

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