Medicare participants with Medigap prescription drug coverage through Medicare supplement insurance can continue with the coverage. If the Medicare participant decides to join a Medicare drug plan, the Medigap prescription drug cover will be removed from the participant’s Medicare supplement plan with an adjustment to the monthly premium. Medigap policies are no longer allowing prescription drug coverage as part of the monthly plan premiums. Approved insurance companies are offering prescription drug plan (PDP) coverage separate and affordable from Medicare PDPs.
Medicare PDPs add prescription drug coverage to Medicare original in the form of costs, fees and medical savings account plans. Medicare Advantage provides PDP coverage as part of the plan under Medicare Part D. The Medicare participant must be enrolled in Parts A and B to enroll in Medicare Advantage Plan. Both PDPs require the Medicare participant to reside in the service area. Enrollments for PDPs are October 15, 2011 – December 7, 2011. The Medicare participant can enroll, change or drop PDPs during this time period. PDP’s services or changes go into effect on January 1, 2012. Medicare participants do not want to go 60 or more days without acceptable prescription drug coverage.
Medicare Part D has a predetermined gap coverage limit for approved prescription drugs. Once the limit is reached the Medicare participant may qualify for a 50 percent cost savings on brand name drugs. Benefits of Medicare gap are the full costs for approved brand name drugs are applied to the Medicare participants out of pocket spending maximums. Gap items include deductibles, co-insurance, and co-payment and approved out of pocket expenses. PDP premium and unapproved drug payments do not apply to the gap limits.