PRESCRIPTION DRUG PLAN

Medicare Part D helps cover the cost of prescription medications, including both brand-name and generic drugs. It’s available to anyone enrolled in Medicare and is offered through private insurance companies approved by Medicare.

✅ Coverage Options:

You can get drug coverage in two ways:

1. Stand-Alone Prescription Drug Plan (PDP)• Adds drug coverage to Original Medicare (Parts A & B)

• Ideal for those who want to keep Original Medicare but need help with medication costs

2. Medicare Advantage Plan with Drug Coverage (MA-PD)• Bundles hospital, medical, and drug coverage into one plan

• Often includes extra benefits like dental, vision, and wellness programs

📋 What Part D Covers:

• Medications listed in the plan’s formulary (approved drug list)

• Drugs in tiers, which affect your copay or coinsurance

• Coverage for brand-name and generic drugs

• Mail-order pharmacy options for convenience

Each plan has its own formulary, so it’s important to check if your prescriptions are covered before enrolling.

💰 Cost Structure:

Medicare Part D plans typically include:

• Monthly premium (varies by plan)

• Annual deductible (some plans waive this)

• Copayments or coinsurance based on drug tier

• Coverage gap (“donut hole”)—you may pay more temporarily after reaching a spending threshold

• Catastrophic coverage—after out-of-pocket maximum is met, you pay significantly less

🧭 Enrollment Tips:

• Enroll when first eligible to avoid late enrollment penalties

• Review plans annually during Open Enrollment (Oct 15–Dec 7)

• Consider Extra Help if you have limited income—this federal program can lower your costs