Under Medicare Part D Which Plan Is Primary?



Medicare Part D is the benefit part of Medicare that helps pay the cost of prescription drugs. When an individual reaches the age of 65 they become automatically eligible to enroll in this plan. This plan is the (PDP) Prescription Drug Plan that covers medications that are prescribed by a physician. Medicare approved private companies provide this coverage. For individuals with additional plans besides Medicare part D, understanding which plan is primary under Medicare part d can help prevent loss of coverage.

Which Plan Is Primary Under Medicare Part D?

If an individual does not understand which plan is primary under Medicare part D when covered by a group health plan, the group plan becomes primary to provide payments first. The secondary payee is Medicare. There are variations to this depending on a few details. Individuals should read and study their coverage so they know what is exactly covered and what is not.

Which Plan Is Primary When There is Double Coverage?

Some individuals are receiving both Medicare and Medicaid. Understanding which plan is primary under Medicare Part D when this is the case is simple as Medicare is the plan that covers prescription drugs.

Which Plan Is Primary When There is Triple Coverage?

When an individual has coverage through their employer and also has Medicare and Medicaid, the individual must be careful because if the individual does not use the Medicare prescription plan they could possibly lose their Medicaid benefits. When an individual works and is covered through their employer and has additional coverage through Medicare and Medicaid, if they apply for Medicare part D they may receive notice that their employee benefits may be lost. If this should occur, discussing this with the insurance provider should be done as they may advise against taking Medicare Part D.



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