Depending on your plan you may need part D

Nevada Medicare Part D - Prescription Drugs

Photo of prescription drugs for Nevada Part D

Nevada Medicare Part D for the prescriptions you take.

Nevada Medicare Part D

The creation of Medicare Part D came by the passing of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. Now prescription drug coverage is available to everyone with Medicare.

Medicare Part A and Medicare Part B is a requirement for eligibility of Medicare Part D. As well as living in the service area of the Prescription Drug Plan, the member wants. If you meet the previous requirements, you can access prescription drug plans through a Stand-Alone Medicare Part D prescription drug plan or a Medicare Advantage Prescription Drug plan.

Medicare Prescription Drug Plans – Nevada Medicare Part D

Medicare Part D, Prescription Drug Plans (PDPs), are available through private insurance companies contracted to Medicare know as stand-alone Prescription Drug Plans. Original Medicare beneficiaries can apply to add a Medicare Prescription Drug Plan.

Which Medicare Advantage Plans may not cover your prescription drugs, e.g.:

  • Individual Cost Plans
  • Private Fee for Service plans (PFFS)
  • Medical Saving Account (MSA) plans

These Advantage plans allow you to add a stand-alone Prescription Drug Plan. You can always get prescription drug benefits through your Medicare Advantage plan if it is available. Remember, if enrolled in a Medicare Prescription Drug plan and then enroll in a Stand-Alone Medicare Prescription Drug plan, Medicare will automatically disenroll you from the MAPD.

Medicare Advantage Prescription Drug Plans

Medicare Advantage Prescription Drug Plans combine the coverage of Original Medicare Part A, Part B, and Part D. Excluding hospice care. Hospice continues to be covered by Medicare Part A under the federal program—concluding that one Medicare Plan includes all your Medicare coverage.

The different types of Medicare Advantage plans:

  • Health Maintenance Organization (HMO)
  • Preferred Provider Organization (PPO)
  • Special Needs Plans
    • Chronic
    • Dual

Any of these Medicare Advantage Plans can Include a Prescription Drug plan. However, they can as easily not come with a Prescription Drug plan. ECSO Medicare Solutions can help you with the specific plan you are interested in enrolling in.

Remember, you must enroll in both Medicare Part A and Part B and live in the service area of a Medicare Advantage plan. This year cannot have end-stage renal disease (with some exceptions).

Medicare may require beneficiaries to pay the monthly premium charged by the plan (if applicable), and these premiums vary by the private insurance provider. Medicare Advantage plans may have $0 premiums. However, everyone must continue to pay their Medicare Part B premium.

Are my prescriptions covered?

Each Medicare Prescription Drug Plan or Medicare Advantage Prescription Drug plan lists the covered prescription drugs in a formulary. Medicare plans that cover prescription drugs break covered medications into different groups called Tiers. The higher the Tier usually means higher copayment or coinsurance costs than lower-tier drugs. The formulary can change at any time of the year. If the formulary changes, you will receive a notification from your Medicare Plan.

Medicare requires all Prescription Drug Plans that cover prescription drugs to include “ALL or MOST” of the prescription drugs in six protected classes:

  • Immunosuppressants
  • Antiretrovirals
  • Antineoplastic (anticancer) drugs
  • Antidepressants
  • Antipsychotics
  • Anticonvulsants
  • Antiretroviral (HIV) drugs

Nevada Medicare Part D does not cover some medications, e.g.

  • Over the Counter (OTC) Medications
  • Fertility Treatment Drugs
  • Hair Growth Medications

Prescription Drug Plans offer many different formularies. Consult with ECOS Medicare Solutions to evaluate prescription drug coverage with your prescriptions.

  • Plan Formularies list their Prescription Drug Coverage
  • Premiums, Deductibles, Copays, and Coinsurance
  • True Out-of-Pocket (TrOOP) costs
  • Prescription Drug Plan limitations
    • Quantity Limits
    • Prior Authorization
  • Network or Preferred pharmacy requirements in the plan evidence of benefits (EOB)
  • Coverage Gap also known as the DONUT HOLE costs
  • Catastrophic Coverage

Choices, what Nevada Medicare Prescription Drug plan is BEST for me?

There is not a one plan fits all Prescription Drug plan. Medicare Prescription Drug plans are different from coverage are to the coverage area. It is so important to consult your Agent. ECOS Medicare Solutions will help you evaluate all the Medicare Prescription Drug Plans in your coverage area.

Many variables may lead you to the Medicare Prescription Drug plan you choose. Your current health situation or costs may lead you to the right plan for you.  Convenience may lead you to choose a Medicare Advantage Drug Plan, or freedom of Primary care choice could keep you in Original Medicare with a stand-alone Medicare Prescription drug Plan.

*Preferred Provider Organizations (PPO) providers are under no obligation to treat Out-of-network plan members unless it is an emergency. ECOS Medicare Solutions recommends that you consult the physician in mind before choosing a PPO. You can also call Customer Service of the plan to determine Evidence-of-Coverage, cost-sharing, and out-of-network services.

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