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Prescription Options Can Be Confusing!

Prescription Options Can Be Confusing!

Posted: April 8, 2021

APRIL 2021

PRESCRIPTION INFORMATION

Are you looking for information on prescription coverage? Did you know that the state of Wisconsin has a prescription plan called SeniorCare? Have you found the Part D quoting tool on the Medicare website? Let’s look at these options in greater detail.


Medicare Part D

  • A federal program administered through private insurance companies that helps with your medication needs. You pay a monthly premium to the insurance company and in return, you use the insurance carrier’s network of pharmacies to purchase your prescription medications. You will pay a copay or percentage of the drug’s cost and the insurance company will pay the rest. There are typically 4 stages of a Part D plan: annual deductible, initial coverage, coverage gap, and catastrophic coverage. Penalties apply if you do not have some type of creditable coverage for your prescription needs.

  • Visit www.medicare.gov/plan-compare to shop for a Part D plan in your area.

  • Click on "Continue without logging in."


  • Answer the questions about the type of Medicare coverage you want. If you are looking for drug coverage only select, "Drug plan (Part D)," then enter your zip code.

  • Answer the question, "Do you get help with your costs from one of these programs?"

  • Click YES to the question, "Do you want to see your drug costs when you compare plans?"

  • Answer the question, "How do you normally fill your prescriptions?"

  • Start typing in your prescriptions, then click "Add Drug."

  • Enter in your dosage, quantity and frequency, then click, "Add to My Drug List."

  • Continue adding prescriptions in this same manner until complete. Then click, "Done Adding Drugs."

  • Choose up to 5 pharmacies, then click, "Done."

  • Review your prescription plan options available in your area.


SeniorCare of Wisconsin

  • A prescription drug assistance program for Wisconsin residents designed to help seniors with their prescription drug costs. To enroll in SeniorCare you must be a Wisconsin resident, be a US citizen or have qualifying immigrant status, and be 65 years of age or older.

  • $30 annual fee for enrolled seniors.

  • Level of coverage in SeniorCare is determined by your annual income. SeniorCare 2021 annual income limits and out of pocket expenses by level can be found at: https://www.dhs.wisconsin.gov/seniorcare/fpl.htm

  • Downloadable application can be sent to SeniorCare in Madison.

  • Considered to be "creditable coverage" because the plan meets or exceeds the standard Medicare Part D plan, so you will not have a penalty if you choose SeniorCare instead of Medicare Part D. There are usually two groups of people who take SeniorCare:

    1. Those who qualify for SeniorCare due to income.

    2. Those who do not fall within the income limits, but don't currently have prescriptions needs. Since SeniorCare is considered creditable, they can go onto the plan for $30/year and not get a penalty.

*Note: that you won't receive many benefits from the plan because you don't fall within the income limits; however, since you aren't taking any medications, it is not an issue. You will still satisfy your prescription requirement and you can change to a traditional Part D plan at any time.

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