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Arizona Medicare beneficiaries can get prescription drug coverage through the Medicare Part D program. Depending on where in Arizona you live, you might have your choice of several Medicare plans that include prescription drug coverage. Availability and costs of such plans in Arizona may vary, but usually you can expect to pay certain costs such as coinsurance or copayments; some plans might charge monthly premium and/or annual deductible amounts.
Medicare offers optional prescription drug coverage through private insurance companies that contract with Medicare under the Medicare Part D program. This coverage is designed to help Medicare beneficiaries cover prescription medication costs. If you have Original Medicare (Part A or Part B) coverage, you can sign up for a stand-alone Medicare Part D Prescription Drug Plan; Part A and Part B usually don’t cover prescription drugs except in certain situations such as inpatient hospital stays.
Each Arizona Medicare plan that includes prescription drug coverage has its own list of covered prescription drugs. This list is called a formulary, and it places all covered drugs in different tiers (categories), each with a different cost. In general, prescription drugs in the lowest tier have lower costs, while drugs in the higher tier will be priced higher. If your doctor believes that a higher-tier drug is necessary to treat your health condition, you can ask your plan for a tiering exception to have a lower copayment for that drug.
Medicare plans that include prescription drug coverage in Arizona (as in all states) typically include both brand-name and generic prescription drugs in their formularies. Generic drugs, according to the Food and Drug Administration, are safe copies of brand-name drugs that use similar active ingredients and offer similar results. The difference is that generic drugs typically cost less than brand-name drugs and result in lower out-of-pocket expenses for Medicare beneficiaries. In certain cases, the generic version of your brand-name prescription drug may not be available, but a similar generic drug that could work just as well for you may be covered. Be sure to discuss all such generic drug options with your doctor or health care provider.
A plan’s formulary may change at any time. You will receive notice from your plan when necessary.
Here are the facts about whether and when you can sign up for in a Medicare plan that includes prescription drug coverage:
Understand that you might be subject to a late enrollment penalty for Medicare Part D, if you don’t sign up during your IEP and don’t have creditable drug coverage for 63 days or more. (Creditable drug coverage is insurance that pays, on average, at least as much as Medicare drug coverage is expected to pay.) In Arizona, as in other states, Medicare calculates the penalty by multiplying 1% of the national base beneficiary premium ($32.74 in 2020) by the number of months you were eligible for Medicare prescription drug coverage but didn’t enroll. Remember that the national base beneficiary premium may increase each year, which means your late enrollment penalty may also go up.
It’s important for you to know that if you choose to enroll in a Medicare plan that includes prescription drug coverage in Arizona (as in other states), you have to stay enrolled in Original Medicare and continue paying your Medicare Part B premium to keep your Medicare health coverage.
You can get Medicare prescription drug (Part D) benefits two different ways:
Here’s a list of some factors to help guide you when you research Medicare plans that include prescription drug coverage.
Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program.