Florida Medicare beneficiaries have options when choosing prescription drug plans. A stand-alone Florida Medicare Part D plan is one such option. Costs for Florida Medicare prescription drug plans (Part D) vary depending on where you live, but most require payment of a monthly premium, annual deductible, and copayment or coinsurance.
Medicare Part D is offered by private insurance companies and is designed to help cover your prescription drug costs. In Florida, as in other states, Medicare beneficiaries can sign up for a Medicare prescription drug plan in addition to plans that don't offer this coverage, like Original Medicare (Part A and Part B), Medicare Supplement plans (Medigap), and certain Medicare Advantage (Medicare Part C) plans.
Each Medicare drug plan has its own list of covered prescription drugs, called a formulary. Covered drugs are sorted into different categories called tiers, each with a different cost. Drugs in the lowest tier usually cost the least, while drugs in the higher tier cost more. If your doctor or health provider decides you need a higher-tier drug to treat your health condition, you might be able to get the drug for a lower cost by requesting a tiering exception from your plan.
Formularies usually include both brand-name and generic prescription drugs. Many brand-name drugs have generic equivalents: the active ingredients, health conditions the drug is used for, and expected results are similar. Generic drugs tend to cost less than brand-name drugs and can result in significantly lower out-of-pocket expenses for Florida Medicare beneficiaries. If the generic version of your brand-name prescription drug is unavailable, there may be a similar generic drug that could work just as well for your health condition. Make sure you discuss all such generic drug options with your doctor.
In Florida, as in other states, you could be subject to a lifetime late enrollment penalty for Medicare Part D if you don't sign up during your Initial Enrollment Period and then add this coverage later on. One way to avoid this penalty (even if you delay Part D enrollment) is to make sure you have continuous creditable drug coverage. This is coverage that pays, on average, at least as well as Medicare is expected to pay for standard drug coverage. If you go without creditable drug coverage for 63 days or more, you're likely to face this penalty. The late enrollment penalty is calculated using 1% of the national base beneficiary premium ($33.13 in 2016) and the number of full months you were eligible for Part D but didn't join. Medicare adds this amount to your Part D monthly premium. Remember that the national base beneficiary premium may increase each year, which means your late enrollment penalty may also increase.
It's important for you to know that if you choose to enroll in a Florida Medicare prescription drug plan, you are still enrolled in Original Medicare and must continue paying your Medicare Part B premium so you won't lose your health coverage.
Another option for Florida Medicare beneficiaries is a Medicare Advantage Prescription Drug plan. With this kind of plan, you get your Original Medicare, Part A and Part B, benefits through a private health insurer that contracts with Medicare. A Medicare Advantage Prescription Drug plan combines health and prescription drug coverage into one private insurance policy, offering at least the same coverage as Original Medicare, and sometimes additional benefits such as vision, hearing, and dental, all in one plan.
If you decide to enroll in a stand-alone prescription drug plan, remember that you need to be enrolled in Original Medicare, Part A and/or Part B. You'll pay the drug plan's premiums in addition to your Original Medicare premium(s).
After reading all this information, how can you decide whether to add prescription drug coverage (Medicare Part D), and which plan to buy?
Medicare drug plan availability and costs vary by state. Here are some statistics on the availability of stand-alone prescription drug plans in Florida:
The following insurance companies sell Medicare prescription drug plans in Florida (as of 2016):
Are you ready to learn about the specific Medicare drug plan options available to you? You can go about it in several ways:
Medicare has neither reviewed nor endorsed this information.
To learn about Medicare plans you may be eligible for, you can: