Part D in Missouri – There is no shortage of Part D prescription plans in Missouri, so you’ll have tons of options when it’s time to enroll. But before you make a selection, you’ll need to know how Medicare Part D works, when you can sign up, and which plans are offered in your area.
What is Medicare Part D?
Part D includes only prescription drug plans. There are two ways you can enroll in Part D.
- As a stand-alone plan that is in addition to your Original Medicare (and Medicare supplement, if you have one)
- As part of your Medicare Advantage (Part C) plan. Medicare Advantage plans that include drug coverage are abbreviated as MAPD plans.
Regardless of which option you choose, your coverage will work the same way. There are several aspects that make up each Part D plan.
Monthly Premium: The cost of having the plan, whether you use it or not. If you have an MAPD plan, you will not pay an additional premium for drug coverage.
Drug Formulary: The list of prescriptions covered by the plan.
Drug Tiers: Categories of prescriptions based on the cost.
Deductible: The annual amount you pay before coverage starts. Many plans waive the deductible for drugs in the first two tiers.
Copays/Coinsurance: The cost you pay to fill (or refill) your prescription.
Pharmacy Networks: Much like provider networks, you’ll get the best prices at “preferred” pharmacies. Pharmacies can also be “standard” or “out-of-network.”
Part D Plans in Missouri
Now that you know the things involved in Part D plans, we can start talking about more specific Part D plans in Missouri.
This year (2022), there are 22 stand-alone Part D plans available to Missouri residents. In addition, there are 109 Medicare Advantage plans that have Part D drug coverage. Fortunately, you won’t have to sort through all of them. Your zip code will determine which ones are available to you.
As far as stand-alone Part D plans in Missouri, there are several available carriers.
- AARP MedicareRx
- Blue MedicareRx
- Cigna
- Humana
- Mutual of Omaha
- SilverScript
- Wellcare
- Clear Spring Health
- Elixir
Each carrier will have a few different plans for your consideration.
When should I enroll in Part D?
You should enroll in Part D as soon as you are eligible or when you lose other credible coverage – whichever happens first.
You are first eligible to enroll during your Initial Enrollment Period, which is a 7-month window around your 65th birthday. However, if you are covered under a group policy – either because you or your spouse still have employer coverage – you can postpone enrollment as long as that coverage is credible. (If the coverage isn’t credible, you’ll pay a penalty when you enroll in the future.)
This is the same rule that applies if you want to delay your Medicare enrollment for Part B. However, Part B and Part D have different “credible” requirements, so make sure you talk to your benefits manager before deciding to postpone.
As long as you have credible coverage in place, you will be eligible for a Special Enrollment Period when you lose that coverage.
Even if you aren’t taking any prescriptions, it’s still important that you enroll in Part D. If you don’t, you will pay a late enrollment penalty when you finally enroll. It takes a while for the penalty to add up to much, but you’ll have to pay it each month for the rest of your life! Fortunately, there are very affordable plans for beneficiaries who have little to no medications.
How do I choose my Part D plan in Missouri?
It does take some time and research to choose a Part D plan. As we’ve mentioned, you’ll need to look at premiums, drug formularies, coinsurance costs, pharmacy networks, and more. That’s quite a few things to compare.
If you are trying to do this on your own, here are the basic steps to get started.
- Look at the drug formulary. Are all of your current medications included?
- Calculate the total estimated cost. This number is the full amount you refilled all your prescriptions for the entire year. (Not including any new ones you might take later.)
- Check the pharmacy network. Make sure you can use a preferred pharmacy. If you can’t, you’ll need to calculate your costs using a standard pharmacy instead.
An easier option is to work with an independent insurance agent! Our agents are Medicare experts and can help you sort through all your options, whether you are looking at Part D plans, Medicare Advantage plans, Medigap policies, and more. Give us a call today and schedule your consultation.