What is Medicare Part D?
What is Medicare Part D?
- Embedded into certain Medicare Advantage plans (MAPD plans).
- Offered as a stand-alone prescription drug insurance policy, used in conjunction with Original Medicare A and B medical coverage and oftentimes alongside a Medicare Supplement plan. Also commonly referred to as a Medicare Part D Prescription Drug plan, or a PDP.
Part D does not cover medical procedures—it only covers prescription drugs. These are only sold by insurance companies.
Medicare Part D Step Therapy
Medicare insurance companies may require you to try a less expensive drug than the one prescribed by your doctor. For instance, let’s say you were prescribed a made-up drug, LakeDrug. LakeDrug helps lower cholesterol, but it’s brand new and costs $500. Let’s also say there are plenty of cholesterol-lowering medications on the market that are cheaper alternative medications that do the same thing as LakeDrug.
Medicare rules say that the company must first give you a limited supply of LakeDrug because that’s what your doctor prescribed. However, the company will have a problem with that because there are plenty of cheaper alternative medications out there that will do the same thing for less money. So, the insurance company will make you, or attempt to make you, switch to a less expensive drug that’s been shown to be effective in lowering cholesterol. If that doesn’t work, they’ll try and make you take another drug, slightly more expensive than the first alternative but still cheaper than LakeDrug. If that doesn’t work, then you can get LakeDrug.
To get LakeDrug without all of this hassle, your prescribing doctor will have to file what’s called an Exception. This is just what it sounds like; the doctor will have to ask the Medicare insurance company to make an exception to their Step Therapy rules to get them to cover LakeDrug.
Medicare Part D Quantity Limits
Simply put, Medicare insurance companies place limits on the number of certain medications you can buy at one time. This is to protect against abuse and waste. There are also exceptions your doctor or health provider can ask for if you bump up against these and have good reasons for not being subject to them.
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Frequently Asked Questions
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Independent Medicare insurance agents and agencies such as Chicagoland Medicare get paid by the insurance companies they represent. The commissions we are paid are already built into the insurance policy you’ve purchased, and there isn’t a way to carve them out of the monthly premium. There is no extra fee for buying a Medicare insurance policy through Chicagoland Medicare, nor will you ever pay a fee for our help.
A local, independent Medicare insurance agent represents multiple carriers so that they can work to give you an unbiased opinion on your Medicare insurance plan options. Chicagoland Medicare agents and agencies are state-licensed, trained, tested and appointed by a hand-selected number of Medicare insurance companies to be able to shop and compare Medicare insurance polices to make sure we find the right fit for you! We explore your healthcare and financial needs and listen to your feelings around options available in your local area. We search for a plan that most closely fits your individual needs and budget.
Is Chicagoland Medicare free? Yes, our services are completely free to you and anything we get paid is paid to us by the Medicare insurance companies.
The monthly premiums you pay for your Medicare insurance policies are exactly the same. You cannot buy a Medicare insurance policy directly from a Medicare insurance company at a lower rate.
We have years of experience selling Medicare insurance in the Chicago area including Illinois, Wisconsin and Indiana.
There are all sorts of differences in the amount of coverage and they type of Medicare insurance coverage you can buy depending on what state and county you live in! Chicagoland Medicare independent Medicare agents have a lot of real-world experience and insight regarding the inner-workings of Medicare insurance companies that you, the consumer, may not have access to, such as Medicare Advantage service areas, Medicare Supplemental (Medigap) annual premium increase trends, application fees, discounts programs and more.
Only independent Medicare insurance agents and agencies like Chicagoland Medicare can offer a variety of plans and an unbiased, multi-company approach so our recommendations are objective unbiased and personalized when we sell you a Medigap, Medicare Advantage or Part D drug plan that’s right for you.
At Chicagoland Medicare, we specialize in Medicare insurance products. Period. We’re not distracted by attempting to sell you life insurance, financial planning services, stocks, bonds or anything else. Medicare insurance is all we do! Unlike many other Medicare insurance agents and brokers, we don’t sell group small business health insurance polices, disability insurance, home or auto insurance. We are a boutique Medicare insurance agency, we like it that way and we’re awesome at what we do.
We only partner with ‘A’ rated, household name, established Medicare insurance companies who offer Medicare Advantage, Medicare Supplement, Medigap and Medicare Part D plans in Illinois, Indiana and Wisconsin.
We do not contract with, nor offer our clients startup, new or state-based, regional Medicare insurance companies. We believe in partnering with established companies for consistency, financial strength and experience.
Sometimes, Medicare insurance agents and agencies try to offer too many different insurance products from too many companies. There are literally thousands of combinations of Medicare insurance plan combinations to choose from in the Chicago area – we choose to focus on a select few of large, reliable, well-established, and financially sound Medicare insurance companies to partner with. Oftentimes, other local Medicare agents and agencies get pulled in too many directions with too many insurance offerings and therefore can’t be as knowledgeable as possible about any carrier or one insurance type over another.
At Chicagoland Medicare, we limit the number of Medicare insurance carriers who have access to our clients. We work hard to know the deep inner-workings of each of our Medicare insurance partners which means our agents and our clients aren’t distracted by small, startup Medicare insurance companies who may have a great product for a year or two, then fade into the background and exit the market. We know our Medicare insurance company representatives by name, and know how to navigate their systems and processes.
The bottom line: Chicagoland Medicare is an independent Medicare insurance agency. We are not owned by a Medicare insurance company or by some large, national entity. We’re your local Medicare insurance agency for the Chicago area. This means we only work with hand-selected Medicare insurance companies so that we can provide you with the best Medicare plan for you that’s individualized and personalized. We exist and work ONLY for our clients, unencumbered by having to push just one company’s Medicare insurance products.