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:
- Stand-alone plans, also referred to as Prescription Drug Plans (or PDP plans), only offer prescription drug coverage.
- 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.