Medicare contracts with private companies to offer beneficiaries prescription drug coverage. These companies offer a variety of options, with different covered prescriptions, and different costs. Beneficiaries pay a monthly premium, a yearly deductible and part of the cost of prescriptions. Those with limited income and resources may qualify for help in paying some prescription drug costs.
The Affordable Care Act requires some Part D beneficiaries to also pay a monthly adjustment amount, depending on a beneficiary's or married couple's modified adjusted gross income. The Part D income-related monthly adjustment amounts for 2017 are $13.30, $34.20, $55.20 or $76.20, depending on the extent to which an individual beneficiary's modified adjusted gross income exceeds $85,000 (or a married couple's income exceeds $170,000), with the highest amounts only paid by beneficiaries whose incomes are over $214,000 (or $428,000 for a married couple).
The monthly Part D premium can be deducted from railroad retirement or social security benefits paid by the RRB, if the beneficiary contacts his or her Part D plan and requests that the RRB withhold Part D premiums. The RRB also withholds Part D income-related adjustment amounts from benefit payments.
Medicare prescription drug plans are voluntary. To enroll, individuals must have Medicare Part A, and must live in the prescription drug benefit plan's service area. Beneficiaries can join during the period that starts 3 months before Medicare coverage starts and ends 3 months after the first month of Medicare coverage. There may be a higher premium if an individual doesn't join a Medicare drug plan when first eligible, and he or she does not have other prescription drug coverage that, on average, covers at least as much as standard Medicare prescription drug coverage. In most cases, there is no automatic enrollment to get a Medicare prescription drug plan. Individuals enrolled in Medicare Advantage Plans will generally get their prescription drug coverage through their plan.
More information about Medicare prescription drug plans, as well as free personalized information, is available online at www.medicare.gov,or by calling the Medicare toll-free number, 1-800-633-4227. Free personalized counseling is also available from the local State Health Insurance Assistance Program (SHIP) and other local and community-based organizations. Beneficiaries can visit the Medicare website to find the organization nearest them.