

Regardless of whether you selected a Medicare Advantage Plan, Original Medicare or Original Medicare with a Medicare Supplement, everyone needs prescription drug coverage at some point in life. If you don't use medications it can be very tempting to overlook prescription drug plans altogether but doing so can actually lead to Late Enrollment Penalties later on if you are without "Creditable Prescription Drug Coverage" for 63 or more consecutive days.
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For many individuals who enroll in a MAPD plans (Medicare Advantage Prescription Drug) the drug coverage is included but there are also MA only plans that do not include drug coverage. Individuals can only be enrolled in either one Medicare Advantage plan or one prescription drug plan at a time. If someone enrolls in either it will automatically cancel the other.
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Premium costs and drug formularies will vary greatly depending on the carrier and zip code. Drug costs will also vary depending on the drug stage. On average prescription drug plans are very affordable and when they are finally needed they can save your family thousands of dollars compared to the small cost of maintaining the drug coverage itself.
Prescription Drug Plans



THREE DRUG STAGES (2025)
Beginning in 2025, Drug plans will be capping the annual out of pocket max at $2,000
(Part B drugs excluded) and eliminating the coverage gap phase (aka donut hole).
This means that after reaching that amount out of pocket, beneficiaries total drug costs the remainder of the year will be $0.
Beneficiaries will also be allowed to spread out prescription drug costs throughout the year. This new payment option can help ease the financial pressure of beneficiaries having to pay large amounts out of pocket all at once for more expensive medications. Payment plans won't reduce drug costs but can help with seniors struggling with budgeting these costly medications. ​
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STAGE 1- DEDUCTIBLE STAGE
-Some plans require you to pay an annual deductible
before your plan starts to pay out toward your drug costs.
-Deductible may vary by Drug Plan.
-No plan may exceed $590 in 2025.
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STAGE 2- INITIAL COVERAGE STAGE
You pay the agreed upon coinsurance for your plan.
Example: If you have a plan with a 25% coinsurance provision and your
medication costs $100,you would pay $25 and they would pay $75.
If you and your insurance together paid out $2,000 on prescription drugs, you would enter the last stage, also known as Catastrophic Coverage.​​
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STAGE 3- CATASTROPHIC COVERAGE
Once you reach the Catastrophic stage you will only be responsible for a small amount of coinsurance/copays for your covered medications
After the end of the year, the stages reset and you go back to stage 1
For more info on Part D, you can visit:
https://www.medicare.gov/about-us/prescription-drug-law
MEDICARE DISCLAIMER
We work with the following companies as an independent broker: Aetna Inc., Anthem Inc., Cigna, Humana Inc., United Healthcare, and Wellcare Health Plans, Inc. Not all plans offer all these benefits. Benefits may vary by carrier and location. Limitations, exclusions, copays, deductibles,and coinsurance may apply.
A non-government entity powered by Innovative Financial Partners, LLC, a health insurance agency. Extra benefits
require enrollment in an MA plan and depend on whether you are eligible to enroll in an MA plan in your area. Benefits are
available only in select areas.
Innovative Financial Group represents Medicare Advantage [HMO, PPO, PFFS, and PDP] organizations that have a Medicare contract. Enrollment depends on the plan’s contract renewal. We do not offer every plan available in your area.
Currently we represent 6 carrier organizations which offer 2,352 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
Some benefits mentioned are a part of a special supplemental program for the chronically ill. Not all members qualify.