with a Part D Drug Plan in which case they are referred to as “MAPD”.
MEDICARE PART D is the Prescription Drug Plan and is separate from all of the other Medicare Plans. Your initial sign-up period mirrors the 7-month enrollment period for Parts A and B. Even if you are not taking prescribed medicines currently, you may still want to sign up for a Medicare Part D Plan because there is a penalty of one percent for every month that you are late after incurring a 63-day continuous period without coverage. This is a cumulative penalty that never expires, meaning you will pay it as long as you have Medicare Part D. Example: Your open enrollment period for Part D ended in May 2014 and you did not sign up until the open enrollment in December 2016. Your penalty is 31 percent of the $35.63 (the national base beneficiary premium for 2017) or $11.10 each month, in addition to your chosen plans monthly premium. Each Medicare Drug Plan has a list of drugs that it covers called a formulary. The drugs that you need are clas- sified in a certain tier of the formulary that determines your costs.
The cost of your Medicare Part D depends on the company you choose, the formulary, and your income (IRMAA applies). If we use the same circumstances we did in the Part B ex- ample and you are married filing jointly with an income of $267,000 to $320,000, you will pay an additional $54.20 plus your plan premium for each person per month. Just as with other Medicare Plans, Your Part D Plan may have a deductible which is an amount you must pay before any benefits begin. No Medicare Part D plan may have a deductible greater than $405 in 2018 and only applies to tiers 3, 4 and 5. Additionally there may be a copay or co-insurance depending on the particular medication or the tier it is in. Part D plans have a coverage gap or “doughnut hole” and the coverage gap begins after you and your plan have spent $3,750 for covered drugs not counting premium. While in the coverage gap, you will pay 35 percent of brand name drugs and 44 percent of generic drugs. The total costs that you pay count towards satisfying the coverage gap. Once you have reached $5,000 in out of packet drug costs in a year, the coverage gap ends, and you will attain catastrophic coverage
status and will then only pay the greater of five percent of the cost or $3.35 for generic and $8.35 for all other drugs the rest of that calendar year. It is essential that you review your particular drug list so that you can choose the best plan.
Medicare Supplement or Medigap Plans are provided by various private Health Plan com- panies and are designed to work in concert with Medicare Part A and Part B. They help to pay the deductibles, co-insurance and copayments for Medicare. There are many different plans but the coverage is the same no matter which company you buy the plan from, although the price can be different. If coverage is established when initial Medicare eligibility is available, then the Medigap Plan is a guaranteed issue. However, if a plan is taken at a later time, then the plan is subject to underwriting and may cost more. Most people age 65 or above purchase a Medigap Plan. In 2020, Medigap Plan F, which is very popular and comprehensive, will no longer be available. However, those who have it at that time or are eligible to have it before 2020 will be grandfathered in. There are
other plans that are equally rich in benefits and may be a better fit for you. Medigap Plans can only be switched or modified on the anniversary date of the policy or else they will be subject to underwriting.
Dealing with Medicare and Medicare Supple- ment Plans can be difficult and hard to understand. You may wish to obtain profes- sional help. Fortunately MDIS is well versed in Medicare and Medicare Supplement Plans and works with many different carriers. We provide no-cost consultations and coordinate your personal medication list and plan design to best meet your needs and desires. Always professional, personal and confidential, we are glad to assist dentists and their families and staff with health care, both while work- ing and in retirement. f
Besides insurance, we can provide other services such as retirement planning and Social Security maximization. Our commitment spans your career from dental student through retirement, and it is our pleasure to serve you. Contact us at
mdis4dds.com or 800-944-7500.
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ISSUE 2 | MAR/APR 2018 | focus 21
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