EPIC Beachy's Pharmacy


Part D

     If you have any questions regarding Medicare Part D, you can call Beachy's Pharmacy at 301-895-5177.  You can also call Medicare at 1-800-633-4227, or visit their website www.medicare.gov. Here is a Medicare-D overview:

1.       Individuals who qualify for Medicare Part D are over 65yrs old or are permanently disabled, and are currently eligible for Medicare Part A or enrolled in Medicare Part B.  There will be prescription drug plans (PDP) and Medicare Advantage Plans (MAPD), formerly known as Medicare + Choice plans, which include health benefits.

2.     Standard benefit - Beneficiaries are expected to pay a monthly premium of approximately $33/month with a $275 annual deductible (when Medicare Part D began).  After meeting the deductible, beneficiaries will pay 25% of drug costs up to $2,510 per year (Medicare covers 75%).  The beneficiary is then responsible for 100% of drug costs between $2,510 and $5,726 each year.  After the beneficiary has reached out-of-pocket spending of $3,216, Medicare will cover approximately 95% of eligible drug costs.

3.     Lower-income beneficiaries eligible for additional subsidy will pay no or reduced premiums and deductibles, and will have low co-payments.  "Dual eliglibles," or Medicare beneficiaries who are also eligible for Medicaid, will also incur little or no out-of-pocket cost according to their level of eligibility.  These patients will be enrolled automatically in the fall and will be given an option to select a specific plan each month.

4.     Medicare D is voluntary.  Patients may opt to keep their present prescription drug coverage including military retiree and veteran's benefits.  If a patient loses coverage or decides to change to Medicare D after the enrollment period (November 15th - December 31st each year), they may be subject to a 1% per month late enrollment fee.  The fee will be waived if they enroll within 63 days of their involuntary loss of previous coverage and they can prove that the previous coverage was comparable to the Medicare Part D benefit.

5.     Each plan will have its own formulary, or list of preferred medications.  The following types of medications are not covered:  prescription vitamins, cough and cold meds, weight loss meds, fertility promotion meds, hair growth meds and barbiturates.  Diabetic testing supplies will continue to be covered by Medicare Part B.



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