Speak with our experienced licensed team: 1-888-865-9086 Monday-Friday: 8:30 am - 6:00 pm EST
Prescription Drug Plans in Florida
Medicare prescription drug coverage or Part D is optional but highly recommended by eMedigap Florida for several reasons. Here are a few to consider from our experts:
Medicare prescription drug coverage or Part D is optional but highly recommended by eMedigap Florida for several reasons. Here are a few to consider from our experts:
a) Part D plans can only be purchased at certain times of the year. Therefore you should consider joining one as soon as there is an election period available to you. You can call our office (888) 865-9086 to see if you qualify. If you decide not to purchase one when you are first eligible and you do not have other creditable coverage or qualify for the Part D Extra Help, you will likely incur a penalty which you will have under current guidelines as long as you have a Part D plan.
b) The 2 ways to obtain Part D plans are to buy a Medicare Advantage plan that includes Part D coverage, or if you have Original Medicare you can purchase a standalone Part D plan from private companies. eMedigap Florida carries many of the leading plans in your area, contact us to get your quote!
c) You can join a Part D plan during your Initial Enrollment Period which runs for seven months beginning ninety days before your age 65th birth month, or during the Medicare Annual Election Period from October 15 through December 07 each year. You may also qualify during the year if you qualify for a Special Election Period(SEP), typically if you move to a new service area, lose other coverage, or qualify for the Extra Help for Part D plans benefit from Social Security.
Your cost for a Part D plan will vary based on several factors including:
1) The prescriptions you take and what tier they fall under for your plan. Typically drug plans have a 5 Tier structure, Tiers 1 and 2 are for generic lower cost drugs, Tiers 3 and 4 are for brand name drugs, and Tier 5 are medications for serious illnesses including cancer and rheumatoid arthritis.
2) The phase of the drug plan you are in. There are four tiers of coverage, the deductible(if the plan has one), the initial coverage stage, coverage gap stage, and catastrophic stage.
3) The plan you choose, premiums, deductibles, copays, and coinsurance will vary by plan.
4) The pharmacy you use. Some plans have preferred pharmacy networks which can lower your cost.
5) Whether you qualify for Extra Help or not. Extra Help for Part D prescription coverage is available from Social Security www.ssa.gov. You can apply anytime and qualification will be based on your income and assets as a single or married person.
- 6) If you have a higher income, you will likely pay more for your Part D coverage. The thresholds currently are $85,000 annual income for a single person, and $170,000 for a married couple. You will pay a higher premium amount if you are above these levels. You will pay the higher amount whether you get Part D with Original Medicare or with a Medicare Advantage plan.
- Drugs that are covered under your plan are listed in the plan’s formulary or drug list. Your plan can provide your formulary or contact our office for assistance. Using the Medicare Plan Finder, we can give you an unbiased recommendation on best plans for you based on your current medication needs.
- Plans may have coverage rules for certain drugs in their formulary to include:
1) Prior Authorization – the prescriber will need to contact the plan before the prescription can be filled. The prescriber may need to show that the drug is medically necessary for the plan to cover it.
2) Quantity Limits – some drugs will have limits on how much can be dispensed at one time.
3) Step therapy – in this case you must try one or more similar, lower cost alternative drugs before the plan will cover the prescribed drug.
Part D and the Veteran’s Administration prescription drug benefit – Any veteran who uses the VA prescription drug benefit can also enroll if they otherwise qualify for a Part D plan. Both plans could not be used at the same time for the same prescription.
Common prescription drug plan FAQs
Get a Quote
Contact us to get the perfect prescription drug plan.
EMedigap Florida, an independent insurance agency, is not affiliated with the Center for Medicare Services (CMS) or the federal Medicare program.
This is a solicitation for insurance.
Brought to you by the John Francis Luchansky Agency, a subsidiary of CleanEarthWater, Inc. a FL Corporation
copyright © 2023 CEW, Inc.
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. We currently offer plans from five organizations totaling thirty two plans. Please contact Medicare.gov or 1-800-MEDICARE to get information on all your options.