Part D Prescription Drug Plans

You can sign up for Part D Prescription Drug Plans, which helps cover prescription drug costs, along with other components of Medicare starting three months before your 65th birthday.

It's important to do this on time because there's a permanent premium surcharge for enrolling more than three months after your 65th birthday if you don't have equivalent drug coverage from another source, such as a retiree plan.

Let us help you with your enrollment

If you are already enrolled in a Part D "standalone" plan or a Medicare Advantage plan that incorporates drug coverage, you can switch plans during the open-enrollment period, which runs from Oct. 15 to Dec. 7 every year.

What Medicare Part D drug plans cover

All plans must cover a wide range of prescription drugs that people with Medicare take, including most drugs in certain protected classes,” like drugs to treat cancer or HIV/AIDs. Information about a plan’s list of covered drugs (called a “formulary”) isn’t included in this handbook because each plan has its own formulary. Many Medicare drug plans and Medicare health plans with drug coverage place drugs into different levels called “tiers” on their formularies. Drugs in each tier have a different cost. For example, a drug in a lower tier will generally cost you less than a drug in a higher tier.

Your actual drug coverage costs will vary depending on:

  • Your prescriptions and whether they’re on your plan’s list of covered drugs (formulary).
  • What “tier” the drug is in.
  • Which drug benefit phase you’re in (like whether you’ve met your deductible, or if you’re in the catastrophic coverage phase).
  • Which pharmacy you use (whether it offers preferred or standard cost sharing, is out of  network , or is mail order). Your out-of-pocket drug costs may be less at a preferred pharmacy because it has agreed with your plan to charge less.  
  • Whether you get Extra Help paying your drug coverage costs.

Note: Starting January 1, 2021, if you take insulin, you may be able to get Medicare drug coverage that offers savings on your insulin. You could pay no more than $35 for a 30-day supply. Find a plan that offers this savings on insulin in your state. You can join during Open Enrollment (October 15 – December 7, 2020).

Choosing a plan

It pays to review your Part D coverage every year, especially if you have started taking new drugs.

  • Start at Medicare.gov, where you can find the basics about the benefit and Part D plans. There's a link to the Medicare Part D Plan Finder, which allows you to compare offerings and coverage options in your area and includes a helpful formulary finder that allows you to compare plans based on their coverage of your personalized list of drugs. It will even show you your monthly out-of-pocket drug cost for the year

Call us to help you understand your options.

Getting financial help

Individuals with annual incomes of less than $18,210 and financial resources of less than $14,100, or married couples with incomes of less than $28,150, might qualify for Extra Help from Medicare to pay their Part D premiums and out-of-pocket drug costs.

Download Medicare's instructions on applying for the Extra Help program.

This information was obtained from www.medicare.gov

By contacting the phone number on this website you will be directed to a licensed agent.