Prescription Drug Plans (Part D)

  • Medicare Prescription Drug Coverage, commonly called Part D, reduces drug costs and protects against medication expenses, but it’s not free. Costs vary depending on the plan you choose.
  • Every health insurance company that offers a Part D plan has its own formulary, or list of covered drugs. Make sure your loved one’s medication is on the formulary.
  • If your loved one already has a Medicare Advantage plan that covers prescription drugs, he or she may not need a Part D plan.

Next Step

If a Part D drug plan seems too expensive for your loved one, look into Drug Assistance Programs that can help with costs.

Learn more

Medicare Prescription Drug Coverage, or Part D, is optional coverage provided by private insurance companies. Part D plans help pay for only those drugs listed on the plan’s formulary and purchased at a pharmacy in the plan’s network.

Your loved one’s Plan D options depend on his or her current health coverage, as indicated below.

Existing health coverage: Original Medicare, Private Fee-for-Service Plan, or Medicare Medical Savings Account
Plan D options: Choose a stand-alone prescription drug plan (PDP) to continue receiving these benefits.

Existing health coverage: Medicare Advantage
Plan D options: Insurance companies that offer Medicare Advantage plans must offer at least one plan that includes drug coverage. Enroll in one of these or choose a stand-alone PDP.

Existing health coverage: Medigap plan (H, I, or J) that includes drug coverage
Plan D options: Either keep current Medigap coverage or enroll in a Part D plan and modify the Medigap plan.

Existing health coverage: Medigap plan without drug coverage
Plan D options: Add a stand-alone PDP.

Existing health coverage: Benefits through a former employer or union
Plan D options: Check with the benefits administrator before making changes to drug coverage.

Existing health coverage: TRICARE, VA, or Federal Employee Health Benefits Program.
Plan D options: Contact the benefits administrator or insurer before making any changes.

When can my loved one enroll?

In most cases, Part D enrollment is offered only during a limited period each year. For details about enrollment and Part D plans available in your area, visit the Medicare website.

Companies that offer Part D plans can change their costs and list of covered drugs every year, so it’s important to review your loved one’s plan regularly. Even if you’re satisfied with the current plan, it’s also a good idea to check annually for a new plan in your area that offers better coverage or a lower price.

Next Step: If a Part D drug plan seems too expensive for your loved one, look into drug assistance programs that can help with costs. Learn More

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