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What is a Medicare Part D Prescription Drug Plan?

No obligation to enroll

Medications are a big piece of your Medicare insurance plan. Original Medicare (Parts A and B) doesn’t cover all prescription drug costs. For Medicare recipients needing prescription drug coverage, a Medicare Part D plan can be purchased:

Another option for obtaining prescription drug coverage is through a Medicare Advantage plan, also called Medicare Part C. If you have Medicare Part C plan, you may be able to get prescription drug benefits if the plan also includes prescription drug coverage. These types of plans are known as Medicare Advantage Prescription Drug plans and they give you the option to get your Medicare health and prescription drug benefits covered under a single plan. With a Medicare Advantage Prescription Drug plan, you get all of your Medicare Part A (Hospital Insurance), Medicare Part B (Medicare Insurance) coverage and prescription drug coverage (Part D). The majority of the Medicare Advantage plans do include prescription drug coverage, although you can purchase a stand-alone Prescription Drug Plan (PDP), if your Medicare Advantage Plan doesn’t include prescription drug coverage.

Medicare Part D Prescription Drug Plans help cover the cost of prescription medications giving you broader healthcare coverage and potentially saving you money. Some of the key things you need to know about the Medicare Part D plans are as follows:

  • Medicare Part D plans are operated by Medicare approved private insurance companies.
  • Part D plans provide prescription drug coverage for both generic and brand name medications.
  • The cost of prescription drug coverage varies depending on the plan you choose, which medications you use and if your pharmacy is in network.
  • Drugs covered and plans can change from year to year.

When evaluating Medicare Prescription Drug Plans, the following questions may be helpful for you to consider:

  • Does the plan cover all of your current prescriptions?
  • Are the premiums for the plan competitive compared to other options?
  • Does the plan work with your preferred pharmacy or allow you to order your medications through mail?

A Medicare Part D Prescription Drug plan is an elective form of Medicare coverage, which means that you’re not required to enroll in one, but there could be significant penalties if you choose to pick up a PDP plan later than your Initial Enrollment Period. To avoid any potential penalties and ensure prescription drug coverage when you need it, you should enroll in Medicare prescription drug coverage when you are first eligible for Medicare.

You can make changes to your prescription drug coverage during the Medicare Advantage and Prescription Drug Plan Annual Enrollment Period (AEP), which runs from October 15 to December 7 each year. Part D plans can change their formulary and benefits each year. The formulary determines how much of the cost of each medication that they will cover, so it is a good idea to review your drug coverage during AEP, which occurs each fall. Even if your medications don’t change, it is possible to save money on a different plan. On the other hand, if you are happy with your prescription drug plan, you can simply allow it to renew automatically at the end of the year.

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  • This guide provides an overview of Medicare coverage and will help you prepare to enroll in the right Medicare coverage to meet your needs and budget.
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