Medicare Part D Coverage
What is Part D prescription drug coverage?
Beneficiaries can choose to enroll in either a stand-alone prescription drug plan (PDP) to supplement traditional Medicare or a Medicare Advantage prescription drug plan (MA-PD), mainly HMOs and PPOs, that cover all Medicare benefits including drugs.
In 2021, 48 million of the more than 62 million people covered by Medicare were enrolled in Part D plans.
Give us a call for an overview of the Medicare Part D program, plan availability, enrollment, and spending and financing,
Already on a Part C or Medicare Advantage? You can join a new plan during the Medicare Annual Enrollment Period.
AEP runs from October 15 to December 7. New coverage choices go into effect on January 1.
Medicare Part D Plan FAQ
Do I need to enroll in a Medicare Part D plan?
If you are enrolled in Original Medicare, you need to enroll in Medicare Part D if you want Medicare prescription drug coverage. If you are enrolled in a Medicare Advantage Prescription Drug Plan, your plan includes prescription drug coverage, so you do not need to enroll in a separate plan. If you choose not to enroll in a Medicare Part D or Medicare Advantage Prescription Drug plan and you do not have creditable coverage through another source, you may be charged a late enrollment penalty if you later decide to enroll in a plan.
How much does Medicare Part D cost?
Plans are offered by private insurance companies, and costs vary. For plan year 2023, the average standard premium is estimated to be $31.50 per month.
Will all of my prescriptions be covered?
Most plans use a drug formulary, which is a list of prescription drugs that are covered. Some prescriptions may not be covered, or they may be covered at a higher out-of-pocket cost. Before selecting a plan, you should check to see whether the prescriptions you regularly take are on the formulary.
How much do I pay to fill each prescription?
Each time you fill a prescription, you may be responsible for a copay or coinsurance cost. Your plan may also have a deductible. The costs vary from plan to plan. Additionally, many plans use a tiered system in which some prescriptions have higher out-of-pocket costs than others.
What if I can’t afford my prescriptions?
If you cannot afford to take the medications your doctor has prescribed, you have a couple of options. You can talk to your doctor to see if a less expensive medication would work as an alternative. If no alternatives are possible and the insurance company has denied covered, you can file an appeal. Another great option is to apply for the Medicare low-income subsidy Extra Help program, which provides financial assistance for qualifying beneficiaries.
Choosing the right Medicare plan is important.
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When you click the button below, you’ll see two options: You can either enter your ZIP code to view the plans available in your area, or use our plan-finder tool to receive helpful guidance.