Medicare Part D. vs. Maryland Plan D

Medicare Part D. vs. Maryland Plan D

Last updated on: October 28, 2022

If you’re new to Medicare, you might be somewhat confused about the differences between Part D and Plan D. Even if you aren’t new, the different types of Medicare and Supplement plans can definitely get complicated! When someone in Maryland refers to Part D, they’re referring to Medicare Part D, the prescription drug plan. When someone mentions Plan D in Maryland, they’re referring to a Medicare Supplement plan.

What Is Part D?

Medicare Part D is the outpatient prescription drug plan. If you are a Maryland resident have Original Medicare Parts A and B, or a Medicare Advantage Plan, you have the option to sign up for prescription drug coverage. Purchasing a Part D plan is not required, but if you decide to enroll in a prescription drug plan after the date that you become eligible, you could end up paying a late enrollment penalty. 

If you are eligible to purchase Part D but don’t think you need it because you aren’t currently taking any prescription medication, think twice before deciding not to sign up for it. If you need prescription medication in the future, you could end up paying the late penalty forever, and it could be many months from the time you need your medication until the time you actually get enrolled in a prescription drug plan.

What Does Part D Cover in the state of Maryland?

Medicare requires all Part D plans to cover at least two drugs in each class of medications. Many plans cover more than that, but it is not required.

For example, Part D covers most drugs in the following categories:

  • Anti-psychotics
  • Anti-depressants
  • Anti-convulsants 
  • Immunosuppressants
  • Cancer medications 
  • HIV/AID drugs

It’s also important to know what medications Part D doesn’t cover. Medicare does not require that Part D cover the following:

  • Barbituates 
  • Cough syrup and other cold medications
  • Prescription vitamins 
  • Fertility or erectile dysfunction drugs
  • Drugs for hair or nail growth, or other cosmetic reasons 
  • Weight loss or weight gain medications 
  • Benzodiazepines
  • Compound medications

Keep in mind that because Part D is offered by private insurance companies, some of the plans may cover the medications listed above. 

Cost of Part D in Maryland

Because the Part D prescription drug plan is offered by private insurance companies, the prices of plans vary. The average Part D premium in 2021 is $33.06 per month. However, the monthly price also depends on your income level. The more money you make, the higher your monthly premium will be.

Part D Deductible in Maryland

The deductible for Part D can change each year. In 2021, the Medicare Part D deductible amount is not allowed to be more than $445 per year. This means that you have to pay $445 out of your own pocket before your prescription drug plan will begin paying for your prescription medications. The deductible resets each year. Part D is regulated by Medicare but offered by private insurance companies, so each plan may have a different deductible depending on which insurance company you purchase it from.

Supplement Plan D - What Is A Medicare Supplement Plan?

Plan D is a Medicare Supplement Plan. If you have Original Medicare, only 80 percent of your covered services are paid for by Medicare once you meet your deductible. This means that you are responsible for covering the remaining twenty percent. There is no out-of-pocket maximum for Original Medicare, so the twenty percent you’re responsible for could add up to basically an unlimited amount of money. 

For example, if you need surgery that costs $100,000, Medicare might pay for $80,000. You would be left paying $20,000. For many people, that would be entirely unaffordable, and they wouldn’t be able to pay for it. This means you might not be able to get the surgery you need, or you might have to go into significant debt in order to get it. 

When you sign up for a Medicare Supplement Plan, it will help pay for some or all of the remaining twenty percent that Original Medicare doesn’t cover.

What Does Plan D Cover if I live in Maryland?

Supplement Plan D covers the twenty percent that Original Medicare doesn’t pay for. Additionally, Plan D pays for the following:

  • Part A hospital co-pay plus an additional 365 days 
  • Part A hospital deductible – in 2021, this amount is $1,484
  • Part B co-pays
  • Skilled nursing facility co-pays
  • Hospice care co-pays
  • First 3 pints of blood
  • Emergency care when you’re outside of the country

What Plan D Does NOT Cover

The two main things that Plan D doesn’t cover are the Part B deductible and Part B excess charges. 

Who Can Get Plan D?

In order to enroll in Plan D, or any supplement plan, you must have Original Medicare Parts A and B. It’s important to note that you cannot get Plan D or any other Supplement Plan if you are enrolled in a Medicare Advantage Plan. In order to enroll in Plan D, you will also have to pay a monthly premium in addition to your Original Medicare premiums. 

Can You Have Both Part D and Plan D?

Yes. If you have Original Medicare Parts A and B, you can also purchase a Part D prescription drug plan as well as A Plan D Supplement. 

Contact Us If You Need Help

If you’re confused about Part D and Plan D, or you’d like to sign up for either or both of these plans and need help figuring out which insurance company to purchase them from, please don’t hesitate to contact us. We have experienced representatives who are happy to walk you through the enrollment process step-by-step. We want to make it as easy as possible for you to take control of your health.

Categories: Medicare Articles, Medicare Part D
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