Medicare Part D in Mississippi – Medicare Part D offers coverage for prescription drugs. You might also hear them referred to as a PDP (prescription drug plan) or an MAPD if it’s part of a Medicare Advantage plan. Every Medicare beneficiary has multiple drug plans to choose from, so it’s important to know how the plans work so you can choose the coverage that’s right for you.
Today, we’ll review how Part D works, which Part D plans are available in Mississippi, and then how to choose the right plan.
How Does Part D Work?
Part D plans are provided by private insurance companies. The companies must meet certain requirements set by the Centers for Medicare and Medicaid Services (CMS) in order to offer the plans. They are only available to Medicare beneficiaries that are enrolled in Part A, Part B, or both.
The most important part of every drug plan is the drug formulary. The drug formulary is a list of prescriptions covered under the plan and categorized into drug tiers. Most plans have four or five tiers as follows:
- Tier 1: generic medications
- Tier 2: preferred, name-brand medications
- Tier 3: non-preferred, name-brand medications
- Tier 4: specialty medications
As you can probably guess, prescriptions in lower tiers cost less than those in higher tiers.
Based on the drug formulary, you’ll have a coinsurance or copayment amount when you fill your medications. You may also have a deductible, but most plans waive the deductible for medications within the first one or two drug tiers. To have the least out-of-pocket expenses, you’ll want to use a preferred pharmacy. Standard pharmacies will work with your plan, but you’ll pay higher coinsurance costs.
One aspect of Part D that is confusing to many people is the donut hole or coverage gap. You’ll find yourself in the coverage gap once you and your plan have spent a certain amount on prescriptions. While in this phase of coverage, you’ll pay up to 25% of the cost of your medications. Not everyone will enter the donut hole, but if you are taking expensive medications, you should prepare for higher costs during this time.
Part D Plans in Mississippi
Mississippi residents have quite a few options when it comes to Part D plans. Below is a list of the eight insurance companies that currently offer Part D plans in Mississippi.
- Clear Spring Health
- Mutual of Omaha
Of those eight different insurance companies, there are 21 different Part D plans. You’ll need to choose from the plans that are available within your zip code.
So, how do you do that? Great question! Let’s talk about how to begin choosing a Part D plan.
Choosing a Part D Plan
Choosing a Part D plan is not always an easy task. You’ll need to spend time reviewing each drug formulary, research which pharmacies are preferred, and determine if you’ll enter the coverage gap. You’ll also want to know how much your prescriptions will cost to refill and if you’ll have to pay the deductible. Here are a few steps to get you started.
- Read through the drug formulary. Are your current prescriptions listed?
- Try to calculate the total cost for the year. If you refilled all your medications, how much would you have to pay?
- Find out which pharmacies are preferred. Are there any in your area, or will you have to travel to get lower costs? You may also check to see if they have a mail order option.
The easiest way to accomplish all this is to enlist the help of a licensed insurance agent! Our agents specialize in Medicare and will help you choose the Part D plan that fits your coverage needs. We’ll make sure you know how the plan works, which pharmacies to use, and when you might see your prescription costs increase.
Our team offers help with your Part D enrollment, as well as your other Medicare plans. If you’re enrolling for the first time, we’ll discuss Medicare Advantage, Medicare Supplements, and other ancillary products. If you’re not new to Medicare, we can review your current plans and make sure they’re still a good fit for you. Our services are 100% free of charge, so call to speak with one of our advisors today!