Community pharmacists are typically the most accessible health care providers for patients and can be a great resource and useful guides for beneficiaries attempting to navigate through the Medicare Part D program.

Background on Part D

The voluntary drug benefit for Medicare beneficiaries known as Medicare Part D developed as a result of The Medicare Modernization Act, or MMA. Medicare does not provide the coverage directly. Private health insurance companies have contracted with Medicare to provide this coverage to beneficiaries.

Eligibility

Beneficiaries must be entitled to the Medicare benefits under Medicare Part A and/or enrolled in Part B to be eligible for Part D. Everyone with Medicare is eligible to join a Prescription Drug Plan (PDP), regardless of income, health status or how much they currently spend on prescription medicines.

Everyone currently enrolled in a Medicare PDP may enroll in plans for coverage between November 15 and December 31 each year, to begin on January 1of the following year. Those covered under Medicaid and Medicare can switch each month. People turning 65 years old, who are eligible for Medicare, can join a PDP as soon as three months before and as late as three months after their 65th birthday.

Plan Selection

Your local community pharmacist can help guide you through the process of choosing and joining the plan that is appropriate for you. Budgetary factors that you will need to take into consideration include how much you want to pay each month for coverage (your premium), how much you want to pay out of pocket for medicines before coverage kicks in (your deductible), how much you want to pay at the pharmacy for each prescription (your co-pay or coinsurance) and which plan(s) cover the drugs you are taking.

Additional Items to Discuss with your Pharmacist

• Are your prescriptions, a generic equivalent, or substitute covered?
• Is your regular pharmacy included?
• What your needs may be in the future

Selecting a plan can be a daunting process. Remember that your community pharmacist is there to provide you with reliable advice and to ensure that you join the plan that is best for your needs.

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