October 6, 2016
Medicare Part D is Medicare’s optional prescription drug coverage program. Available from private, Medicare-improved insurance companies in Alaska, stand-alone Medicare Part D Prescription Drug Plans help Medicare beneficiaries pay for prescription drug costs. Original Medicare, Part A and Part B, includes limited prescription drug coverage (for example, during an impatient stay) but doesn’t cover most medications you take at home.
As a Medicare beneficiary in Alaska, as in all states, you may be able to sign up for stand-alone Medicare Part D Prescription Drug Plan. Each Medicare Part D Prescription Drug Plan in Alaska might have different costs, and may require you to pay a monthly premium, annual deductible, copayments, and/or coinsurance. Not every Medicare Part D Prescription Drug Plan may be available in every part of Alaska.
If you’re already enrolled (or are eligible to enroll) in Original Medicare, Part A and Part B, you can sign up for a stand-alone Medicare Part D Prescription Drug Plan in addition to Original Medicare, if one is available in the area of Alaska where you live.
As in other states, each Medicare Part D Prescription Drug Plan in Alaska has its own list of covered prescription drugs. This list is called a formulary, and it places all covered drugs in different categories (called tiers), each with a specific cost. Drugs in the lowest tier usually cost the least, while drugs in the highest tier are generally priced the highest. If your doctor or health provider believes that a drug in a higher tier is medically necessary to treat your health condition instead of a similar drug in a lower tier, you or your health-care provider can ask your Medicare drug plan for a tiering exception to obtain lower cost sharing for a higher tier drug. The formulary may change at any time. You will receive notice from your plan when necessary.
Medicare Part D Prescription Drug Plans in Alaska (as in other states) may offer you the option of choosing between brand-name drugs and generic drugs, which typically cost much less. The Food and Drug Administration (FDA) requires generic drugs to have the same active ingredient, strength, dosing, administration route, and performance as brand-name drugs. If the generic version of your brand-name prescription drug isn’t available, your pharmacy may offer you a similar generic drug, but be sure to discuss all prescription drug details and substitutions with your doctor or health-care provider.
After your Initial Enrollment Period is over, if you remain without creditable drug coverage for 63 days or more, you could be subject to a late-enrollment penalty for Medicare Part D if you decide to get this coverage later. In Alaska, as in the rest of the United States, the late-enrollment penalty is calculated using 1% of the national base beneficiary premium and the number of full months you were eligible for Medicare Part D but didn’t enroll. This amount is then added to your Medicare Part D monthly premium for as long as you have Medicare Part D. Remember that the national base beneficiary premium may increase each year, which means your late-enrollment penalty may also increase annually.
If you enroll in a stand-alone Medicare Part D Prescription Drug Plan, you have to stay enrolled in Original Medicare and continue paying your Medicare Part B premium in order not to lose your health coverage.
The availability and costs of stand-alone Medicare Part D Prescription Drug Plans vary by location and from one plan to another. When choosing a Medicare Part D Prescription Drug Plan, you may want to take into consideration your individual prescription drug needs. Ultimately, the cost of the drugs you take–more than your drug plan premiums or deductibles–could determine your main out-of-pocket expenses.
Also always remember to review your Medicare Part D Prescription Drug Plan details at the end of each year to stay aware of any changes to your coverage. In Alaska, as in other states, Medicare Part D Prescription Drug Plans are allowed to change their premiums, copayments, deductibles, and drug formularies every year. This means that the plan you’re enrolled in this year may not be the one that fits for you next year-so you may want to shop around for plans each year.
For more information about Medicare insurance plans in Alaska, see the following pages: