Prescription drug plans (Part D), which you can purchase separately from Original Medicare, help cover the cost of your prescription drugs so you can maintain your health and control your conditions as prescribed by your doctor. If you want to purchase a drug plan in New Jersey, you will need to find a plan with coverage in your area that covers the prescriptions you are currently taking. Like Medicare Advantage plans, you can switch or drop your plan each year.
You can purchase a Medicare Part D Prescription Drug plan from the following companies in New Jersey:
- AARP – UnitedHealthcare
- Cigna
- Clear Spring Health
- Elixir Insurance
- Express Scripts Medicare
- Horizon Blue Cross Blue Shield of New Jersey
- Humana Insurance
- Unicare
- Mutual of Omaha Rx
- Aetna Medicare
- WellCare
About Part D Prescription Drug Plans
These plans are stand alone prescription drug coverage offered by private health insurance companies that have been approved by Medicare to provide you coverage. Each of these plans is standardized to provide coverage for at least two prescription drugs in each of the most commonly prescribed categories. You will find coverage for effectively all anticancer, anticonvulsant, antidepressant, antipsychotic, antiretroviral, and immunosuppressant drugs.
The insurance company can choose which drugs to cover. They present these covered drugs in a list called a formulary.
Even if you are prescribed a drug that is not on your plan’s formulary, you may be able to obtain coverage. If the drug cannot be adequately substituted with a drug that is covered by your plan, you and your prescriber can request an exception. You can also do this if you need a drug in a higher quantity than is allowed by the limit.
The insurance company is allowed to make changes to covered drugs throughout the year, such as when a new product becomes available, new FDA regulations are made, or they want to offer a new generic option. If one of the changes affects a prescription drug you are currently taking, the insurer will provide advance notice at least 30 days before the change goes into effect or provide one month’s worth of prescription at the prior rate.
Part D drug plans will each have a different plan premium, but Medicare has a separate charge if you make over a certain sum of money. Called the Part D Income Related Monthly Adjustment Amount (IRMAA), this charge needs to be paid directly to Medicare.
Who Needs a Part D Prescription Drug Plan?
People who regularly take medications to control health conditions should consider purchasing a Part D prescription drug plan or finding a Medicare Advantage Prescription Drug plan, which has the same drug coverage.
Original Medicare (Part A and Part B) provides only limited coverage for certain outpatient medications, so if you take medications and want assistance to avoid paying the full retail cost of your prescriptions, you should find prescription drug coverage.
Comparing Medicare Part D Prescription Drug Plans in New Jersey
The most important consideration when it comes to Part D prescription drug plans is whether or not the plan covers the prescription drugs you are currently taking and provides service in your area.
For more information about New Jersey Medicare Part D Prescription Drug Plans, contact Jersey Medicare Solutions today.
Thomas M. Brzezinski is one of the founding partners of WMAG William & Michael Advisor Group LLC and Jersey Insurance Solutions. He has been involved in the insurance industry for over ten years and specializes in developing client relationships that last a lifetime.
