Medicare Part D is Prescription Drug Coverage
Medicare Part D helps cover the cost of prescription drugs. Part D plans are run by Medicare-approved private insurance companies.
Part D plans can be sold as standalone drug plans and paired with Original Medicare or Medigap. Meanwhile, many Part C plans include Part D coverage.
Part D plans have a premium, although you may qualify for “Extra Help” based on income to lower costs.
In terms of out-of-pocket costs, Part D plans each has a list of covered drugs called a “formulary.” Most plans then place certain drugs in levels called “tiers” and each tier has different costs in different cost-sharing phases. For example, a drug in a lower tier will have a lower cost than in a higher tier, and the cost-sharing of both drugs may be different in the initial coverage phase than they are in the coverage gap phase.
Citation: What Medicare Part D drug plans cover. CMS.Gov.
Thomas DeMichele
Looking for Medicare Plans?
Use the button below to find Medicare Advantage and Medicare Drug Plans.
Already know what plan you are looking for? Try using the search bar.
More Facts on Medicare
Your Drug Plan Can’t Charge More than $35 for a Month of Insulin
Since January 1, 2023, Part D plans can’t charge you more than $35 for a one-month supply of Part D-covered insulin. You also don’t have to pay a deductible for your insulin.
Some People Get Medicare Part A/B Automatically, but Many People Have to Sign Up
Most people are not automatically enrolled in Medicare Part A and Part B and have to sign up during their Initial Enrollment Period. The following are exceptions: If you’re already getting benefits from Social Security or the Railroad Retirement Board (RRB). If you’re under 65 and have a disability. If you have ALS (amyotrophic lateral sclerosis, also called Lou Gehrig’s disease). Meanwhile, Puerto Rico, has special rules for Medicare Enrollment.
Medicare Late Enrollment Penalties
Medicare Part A, Part B, and Part D all have late enrollment penalties for not signing up when you first become eligible. However, with Part A, penalties only apply to those who must pay a Part A premium. Please note each late enrollment penalty has its own rules.
Some Medicare Advantage Plans may include the Medicare Give Back Benefit.
Medicare Advantage plans in certain states and counties may include the Medicare Give Back Benefit. When you enroll in a Medicare Advantage plan that offers the Part B Give Back Benefit, the plan’s carrier will reimburse you for a portion of your monthly Part B premium via your Social Security check.