Understanding Medicare Part D Supplemental in Massachusetts

Medicare Part D Supplemental Coverage helps those with limited means pay for their prescriptions. In Massachusetts, you are still eligible for Medicare Part D even with MassHealth Spend-down once you have reached your spend-down amount.

Definition

• Since January 1, 2006, Medicare Part D Supplemental Coverage has provided people with Medicare prescription drug coverage through private companies. Medicare Part D offers prescription coverage alone or prescription and health care depending on which program you choose. The patient must pay a monthly premium and a share of the prescription costs, though people with limited income may qualify for government assistance.

Eligibility

• People who already receive either Medicare Part A or Medicare Part B are eligible for Medicare Part D Supplemental Coverage. You must already be a Medicare recipient to be able to receive Medicare Part D, as it is supplementary Medicare coverage, not stand-alone coverage.

Annual Deductible and Monthly Premium Costs

• In Massachusetts there is an annual deductible of $250 and a monthly premium of approximately $32.

Costs After Meeting Deductible

• After making your $250 deductible, Medicare Part D pays 75 percent of your prescriptions up to $2,250. Once your prescription costs reach between $2,251 to $5,100, you are responsible for the full cost. After reaching $5,100, Medicare pays 95 percent of your prescription costs.