Prescription drug costs can be difficult to manage without suitable health insurance. Depending on the nature of the disease, its severity and duration, drug treatments can often be prolonged, as is the case with certain chronic illnesses. To handle their medical costs better, Arizona residents already enrolled in Medicare can opt for additional prescription drug coverage. They can also obtain additional benefits by purchasing one of the many Medicare supplements in Phoenix AZ, designed to help with healthcare costs.
Medicare Supplements in Phoenix AZ Basic Facts
In Arizona and the rest of the US, the federal health insurance program, Medicare, provides health coverage benefits to senior citizens aged 65 and older as well as younger adults with certain qualifying conditions (end stage renal failure and Lou Gehrig’s disease) and disabilities. US citizens under 65 and their families are mainly insured through their employers.
Eligible citizens can get their health insurance through the Original Medicare (Parts A and B) or alternatively through Medicare Advantage (Part C) plans, such as HMOs (Health Maintenance Organizations) and PPOs (Preferred Provider Organizations).
For their specific medical needs, many Medicare beneficiaries purchase additional coverage, such as Medicare prescription drug coverage, also called Medicare Part D or Medicare Supplement Insurance, comprising 10 different insurance plans referred to as Medigaps.
If you are not certain which option to choose, you can contact the Arizona State Health Insurance Assistance Program (SHIP) for personalized advice.
Medicare Prescription Drug Coverage Overview
Part D adds prescription drug coverage to the Original Medicare. Its purpose is to lower prescription drug costs and help protect against higher costs in the future.
Medigap users can also purchase Part D, as can people enrolled in a Medicare Advantage plan that doesn’t include prescription drug coverage. Keep in mind that certain Medicare Advantage plans don’t allow for a separate drug coverage option.
Medicare Part D plans are provided through private insurance companies approved by Medicare, so costs and availability may differ between providers and location.
In Arizona, people can get prescription drug coverage through stand-alone Prescription Drug Plans (PDPs) or Medicare Advantage Plans, referred to as MA-PDs, which combine health and drug coverage into one private insurance plan.
Since Medicare requires that all policyholders have some kind of drug coverage, including Part D plans and employer coverage, people are advised to purchase their Part D plan during the first eligibility window (3 months before the month they turn 65 / 3 months after the month they turn 65) to avoid any late enrollment penalties.
Medicare beneficiaries in Arizona can also join a Medicare Part D plan during the annual enrollment period (October 15 -December 7).
The prescription drug plan you choose should reflect your needs in terms of cost, coverage and accessibility (e.g. location of pharmacies included in the plan), so make sure you give it a careful consideration before making a final decision.
Part D Coverage and Costs
Each Medicare Prescription Drug Plan covers a specific list of drugs called a formulary, comprising both generic and brand-name drugs. There are certain drug categories that must be covered by all plans, but the selection of drugs within these categories may vary between providers and plans.
As a rule, all plans must cover at least two drugs from each drug category. They must also cover most drugs belonging to the following categories: anti-psychotics, anti-depressants, immunosuppressive drugs, cancer chemotherapeutics and HIV/AIDS drugs.
Drugs in most formularies are placed into so-called levels or tiers. Drugs in each tier have a different cost, generally in ascending order (meaning a drug in a lower tier costs less than a drug in a higher tier). There are 4 types of costs associated with prescription drug coverage: monthly premiums (in addition to your Medicare Part B premium), annual deductibles (some plans have $0 deductible), copayments and coinsurances, and the so-called coverage gap or donut hole, which begins after policyholders have spent a certain amount for drugs covered under their plan. While in the gap, policyholders are responsible for the full cost of medications until the end of the gap period.
Medicare Part D Plans in Arizona
Arizona residents can choose from a wide range of Part D plans. However, some part D plans may not be available in certain states, so you should always browse plans by zip code to make sure you are looking at the plans offered in your area.
In Arizona, there are 16 insurance companies, offering a total of 32 Medicare prescription drug plans, with different premiums, deductibles and benefits, as given in the examples below:
Lowest Premium Medicare Part D Plan: Humana Walmart Rx Plan $15/month, $320 deductible , no gap coverage
Highest Premium Medicare Part D Plan: Aetna Medicare Rx Premier $133/month, $0 deductible, gap coverage
Lowest Premium $0 Deductible Medicare Part D Plan: SilverScript Choice $18.70/month, no gap coverage
5 Most Popular Medicare Part D Plans:
- ARP MedicareRx Preferred $40.10/month, $0 deductible, no gap coverage
- SilverScript Choice $18.70/month, $0 deductible, no gap coverage
- Humana Walmart Rx Plan $15.70/month, $320 deductible, no gap coverage
- Humana Preferred Rx Plan $26.60/month $320 deductible, no gap coverage
- Humana Enhanced $48.00/month $0 deductible, gap coverage
Medicare Prescription Drug Plans offering gap coverage, $0 deductible
- Humana Enhanced $48.00/month
- Symphonix Premier Rx $92.90/month
- SilverScript Plus $81.10/month
- First Health Part D Premier Plus $99.70/month
- CignaHealthSpring Rx SecureMax $122.80/month
- Aetna Medicare Rx Premier $133.70/month
Some Medicare Prescription Drug Plans under $30, no gap coverage (15 plans total)
- Humana Walmart Rx Plan $15.70/month, $320 deductible
- SilverScript Choice $18.70/month, $0 deductible
- CignaHealthSpring Rx Secure $20.50/month, $320 deductible
- Aetna Medicare Rx Saver $22.60/month, $310 deductible
- United American Essential $23.70/month, $230 deductible
- SmartD Rx Saver $24.80/month, $320 deductible
- Humana Preferred Rx Plan $26.60/month, $320 deductible
- WellCare Classic $26.60/month, $320 deductible
- Transamerica MedicareRx Classic $26.70/month, $320 deductible
- AARP MedicareRx Saver Plus $27.00/month, $320 deductible
- Symphonix Value Rx $27.90/month, $320 deductible
- CignaHealthSpring Rx SecureXtra $28.10/month, $0 deductible
Each Medicare Part D provider in Arizona determines which medications they will cover, the extent of coverage, their network of pharmacies and monthly premiums.
If you are already taking prescription drugs, choose a Part D plan that covers your current therapy needs. Also, make sure to review your plan periodically to make sure you continue to use the best option for your medication needs at that given time.