Medicare Part D and Extra Help

Medicare part D is one of the most frustrating parts of Medicare for most people. Because it’s not something that is issued by the federal government automatically, there are many that don’t know they have the option to enroll in a plan. There are others that don’t know they need it and thousands more that don’t know they have to pay for it. With so many things that are unknown, it’s hard for people to plan for the expense of a Medicare part D plan and need extra help.

Getting help paying for Medicare part D plans isn’t as hard as some would think. While it can take a few phone calls and a little research to find resources, it’s worth it.

Do the Leg Work

Before people can apply for extra help for their Medicare part D plans, they have to know if they have Medicare part D plans. It is possible for people to have this insurance without their knowledge of it if they had help enrolling in any of their Medicare insurance plans. The best way for people to learn what Medicare benefits they have is for people to call Centers for Medicare and Medicaid Services (CMS). If a representative confirms that Medicare part D is active for that person, it’s important to get the following information:

  • The name of the Medicare part D provider
  • The telephone number of the provider
  • An explanation of the benefits they see

With that information in hand, it’s time to call the insurance provider. Any Medicare approved part D provider must provide information to any member regarding their benefits. When speaking to the representative, people should be ready to confirm their address, date of birth and Medicare number. When speaking to these representatives, it’s important to get specific information. If this coverage is a surprise, there are a lot of questions to ask. Some of the most important questions should include:

  • What medications are covered
  • How much do these medications cost
  • Are there any extra help programs assigned to the account
  • How much money should be paid in premiums each month

People should also remember they can request materials be sent to them as well. If they don’t have an insurance card, it’s time to ask for that as well as a formulary and an explanation of benefits.

Finding the Help

An unexpected expense can ruin a budget. Those that are on a fixed budget may find that paying for their medications and the cost of a Medicare part D plan can send people into a tailspin. For those that are in a tight financial situation there is help available.

Low Income Assistance- Medicare part D participants can apply for Low Income Assistance through the Social Security Administration. There are requirements that have to be met but those that qualify can get help paying for their monthly premiums, copays and coinsurance.

SPAPs- SPAPs are State Pharmaceutical Assistance Programs. Not every state has a program like this because they are created by each state. People that live in states with an SPAP can apply and receive help. That help can lower the cost of medications as well as deductibles and premiums.

Patient Assistance Programs- Pharmaceutical companies know there are many people that need medications and it’s too expensive for them to pay for. Instead of ignoring those needs these companies have started Patient Assistance Programs. Many of these programs allow people to apply directly to the company to get their medications at a lower price or free.

Those that have Medicare part D insurance plans have benefits many don’t have. Although the cost of having those plans can be more than expected, there is help available. Those that need more help should call their Medicare part D plan provider to ask about additional resources available.

Nov. 10 14'
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Jul. 7 15'


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