Senior Resources » Medicare Part D: Why This Might Be the MOST Important!

Medicare Part D: Why This Might Be the MOST Important!

Pensive woman in pink pondering Medicare Part D.


            I am retiring January 1st and am beginning to search for the right Medicare option for myself and my wife, who’s undergoing breast cancer treatment at a local cancer facility. Her cancer drugs are expensive, and I’m concerned about the Medicare Part D out of pocket.


I am a diabetic and use the flex pen with high blood pressure prescriptions. Most of mine are generic, except for the diabetic prescriptions. Our Medicare Part B will begin January 1st after my company benefits end December of this year.

What should I do to prepare for this medical insurance change? I will be 70, and my wife is turning 65 by the time I retire. I want to be sure I do this correctly.

Roger, Las Vegas, NV



Medicare is not cookie-cutter. One size does not fit all! During Toni Says® Medicare consultations, we tailor your Medicare to fit your needs. Everyone’s Medicare health and prescription drug situation is different. Your medical situation—as well as the prescription
drugs that you take—should be considered in finalizing your Medicare plan.

The cornerstone of Medicare planning at the Toni Says® office is discussing Medicare Part D prescription drug planning. It is imperative to search for what is the most cost-effective Medicare Part D prescription drug plan that covers all your prescriptions. If a prescription is not covered, whether generic or brand-name, then you will have to pay 100% of that prescription out of your pocket.

Medicare Part D continued…

Many are concerned about their doctor and completely miss if their prescriptions are covered under their new Medicare Part D or Medicare Advantage prescription drug plan due to not focusing on proper Medicare Part D planning. To understand Medicare Part D and the famous “Donut Hole”, visit Chapter 5 of the Toni Says® Medicare Survival Guide Advanced edition.

Every Medicare Part D plan has a formulary—whether it is a stand-alone Part D plan or Medicare Advantage (Part C) with a prescription drug plan. If your drugs are not on that formulary, you will pay 100% out of your pocket.

Medicare Part B is like gold, because of what it offers, and those receiving Medicare Part B for the first time need to understand the value of the Medigap/Medicare Supplement Open Enrollment Period. In the “Medicare and You” handbook, it discusses “When to Buy” a Medicare Supplement. It states that: “The best time to buy a Medigap (Medicare Supplement) policy is during the 6-month period which begins the first day of the month in which you’re 65 or older and enrolled in Medicare Part B.”


Related: Can I Delay Medicare Enrollment?

During this 6-month window, you can enroll in any Medicare Supplement/Medigap Plan without having to answer any health questions, and not be denied coverage. After the 6-month window, then medical underwriting takes place, and you may not qualify for a Medicare Supplement/Medigap Plan.

Woman pondering. Medicare Part D.

Many new Medicare beneficiaries explore the option of a Medicare Advantage Plan, which is known as Medicare Part C. It is a good option, and with health conditions such as you—Roger—and your wife have, we advise that you speak with your doctor about what plans they accept, or if that provider accepts Medicare Advantage plans that you may be exploring.

Medicare Survival Guide Advanced Edition

Order Medicare Survival Guide Advanced

Medicare Survival Guide Advanced (Medicare Part D)

What You Don’t Know Will Hurt You!

Turning 65 in America is a milestone and one of the markers is enrolling in Medicare. But the system is so complicated, and there is a lot of false information out there.

In Toni King’s Medicare Survival Guide Advanced: Basics and Beyond, Toni gives you the critical steps you need to enroll in Medicare properly. Toni shares various situations that she has experienced with her many clients during Medicare consultations, and gives you the information and tools you need to enroll on time to avoid the “famous” Medicare Part B and D penalties.

Medicare Survival Guide Advanced helps you understand Medicare step by step…

Learn How to Enroll the Correct Way
• Still Working Past 65
• Turning 65
• VA Benefits
• Laid-off or Retiring

What Medicare Option Is Best for You
• Medicare Supplement vs. Advantage
• Losing Retirement Benefits

How to Avoid
• The Donut Hole
• Part B Penalties
• Part D IRMAA Penalties

If you are enrolling in Medicare and are confused by the commercials and telemarketers, or from the information that well-meaning friends or family members give, let Toni guide you through the maze of Medicare. Order TODAY!

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Originally published December 14, 2022

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