top of page

Medicare Part D

Also known as Medicare's Prescription Drug Benefit

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

1. 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.

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.

How To Join A Plan

  • Enroll though 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 contact Medicare to enroll.

Did you know there is a penalty if you don't get prescription drug coverage?

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) (like an HMO or PPO)

  • Another Medicare health plan that offers Medicare prescription drug coverage

  • Creditable prescription drug coverage 

bottom of page