Medicare Part D

Medicare Part D

Also known as Medicare's Prescription Drug Benefit

Medicare Part D

Medicare Part D is a Medicare program designed to finance the costs of prescription drugs and prescription drug premiums. Medicare Prescription Drug Plans are stand-alone drug plans that add prescription drug coverage to Original Medicare. Plans assist with the cost of prescription drugs, vaccines, and some medical supplies not covered by Medicare Part A and Part B.

What exactly do plans cover?

Each Medicare Prescription Drug Plan has its own list of covered drugs. These are called a formulary. Many Medicare drug plans place drugs into different “tiers” on their formularies. Drugs in each tier will have a different cost. A drug in a lower tier will generally will be less expensive than a drug in a higher tier. In some cases, if your drug is on a higher tier and your doctor thinks you need that drug instead of a similar drug on a lower tier, you or your prescriber can ask your plan for an exception to get a lower copayment.

Two Ways To Get Prescription Drug Coverage

Medicare Prescription Drug Plan (Part D). These plans (sometimes called “PDPs”) add drug coverage to Original Medicare. If you are purchasing a Medicare Supplement you will want to combine it with a PDP plan.

Medicare Advantage Plan (Part C), like an HMO or PPO, or other Medicare health plan that offers Medicare prescription drug coverage. You get all of your Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage, and prescription drug coverage (Part D), through these plans. Medicare Advantage Plans with prescription drug coverage are sometimes called “MA-PDs.” You must have Part A and Part B to join a Medicare Advantage Plan.

How To Join A Plan

  • Enroll through an agency (like us)
  • Enroll on the Medicare Plan Finder or on the plan’s website
  • Complete a paper enrollment form
  • Contact the plan or Medicare to enroll

Make Sure To Avoid Late Penalties

The late enrollment penalty is an amount added to your Medicare Part D monthly premium. You may owe a late enrollment penalty if, for any continuous period of 63 days or more after your Initial Enrollment Period is over, you go without one of these:

  • A Medicare Prescription Drug Plan (Part D)
  • A Medicare Advantage Plan (Part C)
  • Another Medicare Health Plan that offers Medicare prescription  drug coverage
  • Creditable prescription drug coverage

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