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Medicare Part D


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Medicare Part D Information

Medicare offers prescription drug coverage to everyone with Medicare.  If you decide not to join a prescription drug plan when you are first eligible, and you do not have other drug coverage, you may be charged with a drug penalty.

To get Medicare drug coverage, you must join a plan run by an insurance company .

2 ways to get drug coverage

 

1.  Medicare Prescription  Drug Plan (Part D).  These plans (sometimes called "pdp's").

 

2.  Medicare Advantage Plan(Part C) like an HMO or PPO.  You must have Part A and Part B to join a Medicare Advantage Plan.

What drug plans cover

Each Medicare Prescription Drug Plan has its own list of covered drugs (called a formulary).

A drug in a lower tier will generally cost you less than a drug in a higher tier.  In some cases, your prescriber or you can ask your drug plan for an exception to get a lower coypayment.

Medicare Part D

Medicare offers prescription drug coverage to everyone with Medicare. If you decide not to join a Medicare Prescription Drug Plan when you're first eligible, and you don't have other creditable prescription drug coverage, or you don't get Extra Help, you'll likely pay a late enrollment penalty. To get Medicare drug coverage, you must join a plan run by an insurance company or other private company approved by Medicare. Each plan can vary in cost and drugs covered.

  
2 ways to get drug coverage

    1. Medicare Prescription Drug Plan (Part D). These plans (sometimes called "PDPs") add drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private Fee-for-Service (PFFS) Plans, and Medicare Medical Savings Account (MSA) Plans.

    2. 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.

What drug plans cover

Each Medicare Prescription Drug Plan has its own list of covered drugs (called a formulary). Many Medicare drug plans place drugs into different "tiers" on their formularies. Drugs in each tier have a different cost. 

A drug in a lower tier will generally cost you less than a drug in a higher tier. In some cases, if your drug is on a higher tier and your prescriber 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.

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