2014 Medicare Part D Plans: What’s New for Medicare Drug Coverage?

October 7th, 2013 | Posted by Angela Chen in Medicare Costs | Medicare Coverage | Medicare Part D | Medicare Plans
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2014 Medicare Part D Plans: What’s New for Medicare Drug Coverage?As Medicare plan benefits and costs vary each year, beneficiaries can expect changes for 2014 Medicare Part D plans.

Medicare Part D plans offer prescription drug coverage to eligible seniors and disabled individuals. This insurance plan is offered by health insurance companies approved by the government. Many beneficiaries opt to enroll in Part D plans given that Original Medicare, Part A and Part B, do not cover most medications. Also, not having creditable prescription drug coverage for a certain period of time may result in a late enrollment penalty. During the Annual Election Period, which lasts from October 15 through December 7, eligible beneficiaries can make changes to their Medicare health and drug coverage options, such as their 2014 Medicare Part D plan.

2014 Medicare Part D plan options

  • Medicare Prescription Drug Plans, also known as PDPs, are stand-alone private insurance plans that add additional drug coverage to your existing Original Medicare and/or Medicare Supplement (Medigap) coverage. Certain Medicare Advantage plans that do not offer prescription drug coverage, such as Medicare Cost plans, Private Fee-For-Service (PFFS) plans, and Medicare Savings Account (MSA) plans, may allow a separate enrollment in this type of plan. To be eligible to enroll in a PDP, you must be enrolled in either Part A or Part B.
  • Medicare Advantage Prescription Drug plans, also known as MAPDs, are private health insurance plans that combine health benefits and prescription drug coverage into one plan with one monthly premium. In most cases, prescription drugs are covered in Health Maintenance Organization (HMO), Preferred Provider Organization (PPO, and Special Needs Plans (SNPs); however, there may be other types of MAPDs available. To be eligible to enroll in an MAPD, you must be enrolled in both Part A and Part B.

Coverage for 2014 Medicare Part D plans

The coverage of 2014 Medicare Part D plans will vary between the different plan options offered by various insurance companies. Each Part D plan has its formulary, or list of covered drugs, and each will place medications into different “tiers” in the formularies, which will affect how much they will cost. Generic drugs are generally placed in lower tiers, and drugs in lower tiers will generally cost less than those in higher tiers, which may include brand-name drugs. 2014 Part D plans may enforce coverage rules before it pays for its share of eligible medications, such as requiring prior authorization or step therapy before covering a drug.

In 2014, you can continue to get your prescription drugs from either eligible local pharmacies or through mail-order pharmacies. In the past, Part D plans were not making sure that some beneficiaries still wanted or needed a drug before automatic refill systems sent them through the mail. Starting in January 2014, the government is encouraging 2014 Medicare Part D plans to get your consent for a new or refill prescription before each delivery, except in cases when you actively request the prescription. Make sure to communicate with your drug plan so that the delivery of your medication orders is not delayed. Keep in mind that this does not affect reminder programs where you pick up prescriptions in-person or at long-term care pharmacies.

Creditable prescription drug coverage in 2014

Enrolling in a Part D plan when you are first eligible will help you avoid any penalties for not having creditable prescription drug coverage. This is defined as drug coverage that is at least as good as that which is offered by Medicare Part D. The government requires all individuals who are enrolled in Medicare to have creditable prescription drug coverage.

If you go 63 or more days in a row without this coverage, you will be subject to a late enrollment penalty that will be applied to your monthly premium for as long as you are enrolled in Part D. The amount of this penalty changes each year as it is based on the national benchmark premium for Part D plans that year times the number of full, uncovered months you were eligible, but did not enroll in a Part D plan. In 2014, the Part D late enrollment penalty will be $0.32 for each month you went without creditable prescription drug coverage.

During this year’s Annual Election Period (AEP) for 2014 Medicare plans, be sure to compare your plan options and make sure that you have creditable prescription drug coverage that is sufficient for your needs in the coming year. To compare Part D plans in your area, you can use our free, no-obligation Medicare plan comparison tool. Plan rates and benefits for 2014 Part D plans will be available after the AEP begins on October 15.

 

Medicare hasn’t approved or endorsed this information

About

As a contributor and editor of the PlanPrescriber Blog, has extensive knowledge about the Medicare program and the various associated private insurance products, including Medicare Advantage, Medicare Part D, and Medicare Supplement (Medigap) plans. Her areas of interest include health and wellness, marketing, journalism, and social media.

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