Medicare Part D Prescription Plans

Original Medicare (Parts A and B) DOES NOT offer prescription drug coverage. Medicare requires creditable drug coverage either from a private insurance company or through an employer/union.

If you decide not to join a Medicare Prescription Drug Plan when you are first eligible, and you don’t have other creditable prescription drug coverage, you’ll likely pay a late enrollment penalty later down the line when you eventually need the coverage.

If you do not have prescription coverage through and employer/union, you must join a plan run by an approved Medicare insurance company. Each plan can vary in cost and drugs covered and it is important to review how you medications are coverage annually as that can change from year to year.

Each Medicare Prescription Drug Plan has its own list of covered drugs, known as a formulary. Many Medicare drug plans place drugs into different “tiers”. Drugs in each tier have a different cost. A drug in a lower tier will generally cost you less than a drug in a higher tier.

2 ways to get drug coverage:

• Medicare Prescription Drug Plan (Part D). These plans add drug coverage to Original Medicare, some Medicare Cost Plans, and some Medicare Private Fee-for-Service (PFFS) Plans. Typically, these types of plans are paired with a Medicare Supplement plan.
• Medicare Advantage Plan (Part C) (like an HMO or PPO) that offers Medicare prescription drug coverage. You get your Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage, and prescription drug coverage (Part D), through these plans. Medicare Advantage Plans with prescription drug coverage are sometimes called “MAPDs.” You must have Part A and Part B to join a Medicare Advantage Plan.