Why Your Part D Medicare Does Not Come Directly From The Federal Government

Why Your Part D Does Not Come Directly From The Federal Government

Every once in awhile, we have someone walking into our office frantic about losing their prescription coverage. The story typically goes something like this:

“I got my Medicare, and I had prescription coverage from the federal government, then my pharmacy said my plan ended and I would not have coverage until open enrollment.”

The first couple of times, this really confused me.  Just like the boogie man, sightings of Steve Jobs in remote Africa, and to some folks - the moon landing, Part D directly from the federal government is not real.  Part D is administered by private insurance companies. In any given state, there are over 20 different options to choose from.  Sometimes, Part D is rolled into a Medicare Advantage plan, or Part C as part of an all in one package.

Stand alone Part D plans always have a monthly premium (unless you have Medicaid) and they always come from a private insurance company. Individuals can typically choose to pay for a Part D plan through a direct social security deduction, check, EFT, or sometimes credit card.

If you think your Part D coverage comes directly from the Federal Government, it’s either you’re unaware of what company you purchased your coverage from (it’s a good time to make sure your premiums are paid so you do not have any mid year surprises) or you simply do not have coverage - in which case you’ll rack up a 1% a month penalty tagged on for the rest of your life when you do sign up for Part D.

For some reason you’re unaware that you signed up for a Part D, double check your bills to make sure premiums are paid.  We unfortunately see too often folks who do not pay their bills due to the misconception that “everything is covered by the government and I shouldn’t have to pay anything” and having a mid year surprise where they’re dropped from the plan.

If you’re dropped for non-payment, you won’t be able to enroll until October for a January 1st effective dates. Ignore the moon landings and make sure you know what company you’re getting your Part D from.


Johnny Luo M.D.Comment