What is PDP and Why Do I Care on Medicare? A blogafo (blog with information)

PDP stands for Prescription Drug Plan. Basic Medicare does not help with prescription drugs. They have made a way for you to have good coverage through qualified partnerships with insurance carriers. You need a good prescription drug plan.

PDP is not like supplements or Medigap. And supplements do not cover prescription drugs. If you have a supplement, you need a PDP also. We can help with that.

PDP is not like Advantage; however, many Advantage plans have PDP included. You need to know if you are on an Advantage plan the amount and coverage for PDP. Every carrier can be a little different in copays, coinsurance, donut hole coverage, how they handle tiers of drugs. We can help with that.

PDP is not like vision, hearing, or dental. Some advantage plans have some extra features that include these and you need to understand that. Supplements do not have these extra features, but you can add coverage to obtain them. We can help with that.

Each PDP has a star rating provided by feedback and analysis of the CMS. It is important to know this rating for a plan in your area. We can help with that.

During the annual enrollment period you can change PDP with no concerns about medical underwriting. Now, if it is part of your Advantage plan, you would need to change the full plan. We can help with that.

All PDPs are not alike. Each has a different formulary that tells you what drugs they cover and at what price to you and to them. This is important to know if you are taking special medications or even medications normal for seniors like blood pressure meds. We can help with that.

All PDPs are not alike. Pricing is different sometimes in every zip code and can vary by age and experience of people in that area and contracts the PDP has with local providers. One nationwide plan just made significant changes that assist in low to no co-pays in certain areas. You need to understand historically how a PDP has changed pricing over time. We can help with that.

Delaying on your PDP beyond initial eligibility periods can mean two issues. One, you can incur a penalty charge that affects your insurance amount for life. Whoops. Don’t want to do that. Two, you could end up having to go through medical underwriting and struggle to get the coverage you want at the price you want. Whoops. Don’t want to do that.

Resources for More Information:

The official CMS (Center for Medicare and Medicaid Services) page on PDP is https://www.medicare.gov/drug-coverage-part-d/how-to-get-prescription-drug-coverage. It is a good, quick cover sheet on PDP. What we have done here is help you go beyond the basic facts and answer some questions.

Our partner powered by grandkidsmatter.org have a good breakdown on PDP at http://grandparentbenefits.org/medicare-part-d/.

Okay, I hope this little blogafo (blog with information) helps you today get a step closer to a good decision that fits your needs. We can help with that.


405.494.0637. Call/text

Published by Phil Larson

Community leader, business leader, writer, dad, friend, amigo, hermano. Passionate about every activity in which I choose to participate.

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