Medicare Part D

Your Medicare Part D and Advantage Plan Facts:

(Open Enrollment is Oct. 15 – Dec. 7)

  • 30+ Plans Available
  • Some plans can have a deductible up to $320.00
  • Premiums range from $18.00- $120.00 per month

Medicare Part D Meetings at your local Cannon Pharmacy

Schedule a FREE Medicare Part D plan review with one of our Medicare Part D experts. Call your local Cannon Pharmacy today!

  • Let us help guide your family with enrollment.
  • Are having trouble paying for your medications? Ask us if we can help you qualify for prescription assistance (LIS).
  • Use our 6 month supply ad to save money and help keep you out of the donut hole.
  • We can make recommendations to reduce your monthly cost when approved by your Doctor and supported for your health care needs!
  • Do you have a drug need not covered under your current plan? Call and ask us how we can help!
  • We also carry medical equipment and diabetic testing supplies that can be supplied by Medicare Part B in many cases.

Things You Need to Know About Medicare Advantage

  • Medicare Advantage is also called Medicare Part C.
  • Combines Medicare Parts A, B and D.
  • Replaces Traditional Medicare (no need for a Medicare supplement)
  • Pros:
    • Cheaper premiums
    • No need for supplement (save monthly supplement premiums)
    • Premiums not based on age or health
    • Fixed copayments for hospital, doctor, etc. (eliminates guessing)
  • Cons:
    • Must follow rules of private company
    • May limit to certain doctors/hospitals
    • Bound by the company’s drug formulary
  • HMO:
    • More restrictive network
    • Must stay in network for coverage
  • PPO:
    • Preferred Provider Organization
    • Can go out of network if needed

Medicare Part D Coverage Facts for 2016

  • Initial Deductible up to $320
  • Initial Coverage Limit $3,310 (patient & plan spend)
  • Out-of-Pocket Threshold $4,850 (patient spend & manufacturer discount payment)
  • Coverage Gap (donut hole) begins once the patient reaches the Medicare Part D plan’s initial coverage limit and ends when the patient reaches the out of pocket threshold spend
    • Brand-Name Drugs – the patient pays 45%, the plan pays 5%, and the manufacturer pays 50% of the full cost while in the coverage gap
    •  Generic Drugs the patient pays 52% and the plan pays 48% of the full cost while in the coverage
  • Catastrophic Coverage begins once the patient reaches the out of pocket threshold spend
    • Brand-Name Drugs – the patient pays the greater of 5% of the full drug cost or $7.40
    • Generic Drugs the patient pays the greater of 5% of the full drug cost or $2.95

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