Understanding Medicare, Parts A-D

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Medicare Plan Review

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Understanding Medicare A-D, plus, the Affordable Care Act

What is Medicare?

Medicare is health insurance that the federal government offers to most people 65 and older and some younger people with disabilities. It's broken down into four different "parts": A, B, C (or Medicare Advantage) and D.

When you sign up for Medicare you automatically get Part A, which covers hospital bills. But you must enroll if you choose:

Part B - covers inpatient/outpatient doctor visits, many preventive care services, and medical items such as diabetes testing supplies, home medical equipment and nebulizers (covered at Walgreens2)

Part C - also referred to as Medicare Advantage (MA). MA plans are offered by private insurers and cover the same services as Parts A and B, plus some plans offer additional benefits. MA plans that offer prescription drug coverage are referred to as MA-PD plans.

Part D - prescription drug coverage provided by private insurance plans

If you're 65 or older (or have a Medicare-qualified disability), and know you'll have at least one medical prescription going forward, then a Part D plan is something you should carefully consider.

Premiums
You'll pay a monthly premium for your prescription drug plan. Sign up when you first qualify to avoid paying higher premiums in the future.

When you turn 65, the Centers for Medicare and Medicaid Services (CMS) provide you with coverage information you'll need to get started. Typically, you have 3 months before and after your birthday month to choose a Part D plan. If you don't enroll when first eligible, you will pay a 1% penalty per month — up to 12% each year.

So if you think you might need Medicare Part D later, you'll save by choosing a plan now.

Your Walgreens pharmacist can help
Your local Walgreens pharmacy knows your prescription history, and we offer services to help you stay well including:

  • Vaccinations
  • Health tests
  • Comprehensive medication reviews

A Walgreens pharmacist can even help you review Medicare plans in your area if you're still unsure about coverage options.

If you currently have Medicare coverage, theres no need to do anything with the new Health Insurance Marketplace created by the Affordable Care Act (ACA). Your coverage is already secured, and in some ways, has improved:

  • As a part of the ACA, Medicare now covers certain preventive services, like mammograms or colonoscopies, without charging you for the Part B coinsurance or deductible. You also can get a free yearly "Wellness" visit.
  • If you're in the "donut hole" (see below), you'll also get a 50% discount when buying Part D-covered brand-name prescription drugs.
  • New initiatives support care coordination with your doctor, which means more resources to ensure consistent treatments.

During Medicare's Annual Enrollment Period (also known as open enrollment), which runs from October 15 - December 7, you may change your prescription drug plan for the following calendar year.

Plan details, your healthcare needs and your prescriptions can change — so evaluate your Part D plan each year.

Get a FREE Part D Plan Report at your neighborhood Walgreens. Meet with your pharmacist ›

The Medicare Part D funding gap - commonly known as the "donut hole" - will close in 2020. Until then, you'll see improved benefits to help pay for your prescription medications.

In 2014, the price discount is 28% on generics and 52.5% on brand-name prescription drugs.

Learn more about the Part D Donut Hole ›

1 Information provided by Walgreens is not a substitute for your own research concerning your health care, including Medicare.

2 Walgreens is an accredited Medicare Part B supplier of diabetes testing supplies.