Part D
Prescription Drug Plans
Standalone Part D plans help pay for your prescription medications, protecting you from high drug costs.
Essential Medication Coverage
Original Medicare generally does not cover the prescription drugs you take at home. To get this coverage, you must join a Medicare-approved Part D plan offered by a private insurance company.
Standalone vs. Integrated
Part D plans are standalone policies designed to work alongside Original Medicare and Medicare Supplement (Medigap) plans. If you enroll in a Medicare Advantage plan, it will likely already include prescription drug coverage.
How Do Part D Plans Work?
The Formulary
Every plan has a formulary (list of covered drugs). Drugs are placed into "tiers" — lower tiers generally cost less.
Monthly Premium
You pay a monthly premium to the insurance company for your Part D plan, which varies by plan and location.
Deductible
Many plans have a yearly deductible you must meet before the plan begins to pay its share for your medications.
Copays & Coinsurance
After meeting the deductible, you pay a copayment or coinsurance for your covered drugs.
What to Consider
Pharmacy Networks
Most plans have preferred pharmacies where you'll pay lower copays. Going out-of-network can cost significantly more.
The Coverage Gap
Also known as the "donut hole", this is a temporary limit on what the drug plan will cover for drugs after you and your plan spend a certain amount.
Late Enrollment Penalty
If you go 63 days without creditable drug coverage, a permanent penalty is added to your premium when you finally enroll.
Who Needs Part D?
- Anyone with Original Medicare or a Medigap policy.
- Those who currently take daily prescription medications.
- Healthy individuals who want to avoid the lifelong late enrollment penalty.
When can you enroll?
You can enroll in a Part D plan during your Initial Enrollment Period. If you need to make changes to your plan, the best time to do so is during the Annual Enrollment Period (Oct 15 - Dec 7) each year, as plan formularies and costs can change.
Compare Part D Plans
Provide your medication list, and we'll help you find a prescription drug plan with the lowest out-of-pocket costs for your specific needs.