Medicare Part D

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What is a Medicare Part D Prescription Drug Plan? (Medicare Drug Plan)

Medicare Part D Prescription Drug plans (“PDPs”) add drug coverage to Original Medicare coverage, some Medicare Cost Plans, some Medicare Private Fee-for-Service (PFFS) Plans, and Medicare Medical Savings Account (MSA) Plans.

What do drug plans cover?

  • Each Medicare Part D Prescription Drug Plan has its own list of covered drugs (called a formulary). Many Medicare drug plans place drugs into different “tiers” on their formularies. 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. In some cases, if your drug is on a higher tier and your prescriber thinks you need that drug instead of a similar drug on a lower tier, you or your prescriber can ask your plan for an exception to get a lower co payment.
    • A Medicare drug plan can make some changes to its formulary during the year within guidelines set by Medicare. If the change involves a drug you’re currently taking, your plan must do one of these:
      • Provide written notice to you at least 60 days prior to the date the change becomes effective.
      • At the time you request a refill, provide written notice of the change and a 60-day supply of the drug under the same plan rules as before the change.

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Contact us to learn more about the right insurance coverage for you.

Attention: You may be eligible for financial assistance for prescription coverage through the Medicare Extra Help program. This subsidy is for those with a low-income and can provide an estimated savings of $4,000 yearly.