Medicare Part D Prescription Drug Plans

Medicare Part D plans are offered by private companies to help cover prescription drugs. Everyone with Medicare can get this optional coverage to help lower their prescription drug costs. Medicare Part D covers both brand-name and generic prescription drugs at participating pharmacies.

There are two types of Medicare Part D coverages:

  1. Stand-alone plans, also referred to as Prescription Drug Plans (or PDP plans), only offer prescription drug coverage.
  2. Medicare Advantage plus Prescription Drug (or MAPD) plans offer prescription drug coverage as well as medical coverage for doctor visits and hospital expenses.

Each Part D plan has a formulary (drug list) – a list of government-approved medications the plan will cover. This list may also be referred to as a prescription drug list (PDL) or a covered medications list (CML). Drug coverage varies from one plan to another, so if you are considering a Part D plan, you may wish to review the plan’s Prescription Drug List to be sure it will meet your needs.

How does Medicare Part D work?

  • Like other types of insurance, Part D plans may have a monthly plan premium and a yearly deductible. These vary from plan to plan.
  • You pay a portion of your drug costs, including a copayment or coinsurance. Costs vary depending on which drug plan you choose.
  • Coverage options, including drug coverage, may vary from plan to plan.

**If you do not take prescription drugs at this time, but are eligible to enroll in Part D, you may want to consider being covered now. If you select a plan that does not cover prescription drugs and you do not have another qualifying prescription coverage you will pay a penalty in the future should you decide to enroll in a Part D plan later.