Medicare Part D

Medicare Part D, also called the Medicare prescription drug benefit, is an optional United States federal-government program to help Medicare beneficiaries pay for self-administered prescription drugs through prescription drug insurance premiums (the cost of almost all professionally administered prescriptions is covered under optional Part B of United States Medicare).

Part D can be purchased independently or as part of a MAPD, Medicare Advantage Presciption Drug Plan.

Medicare Part D Coverage

Part D Plans each have their own formulary based on a master formulary provided by Medicare. Usually, the more expensive the plan the greater the number of medications in that plans formulary.

All Part D plans must provide medications in each major health classification. Part D Plans have 5 Tiers of medications with Tier 1 being Preferred Generic and Tier 5 Specialty Drugs. If you take a medication not on formulary you may request an exception.

How much does Part D cost?

Premiums for Part D Plans vary and the more medication included in the formulary the higher the cost.

Our Medicare Part D Specialist can take your list of medications and tell you which plan will give you the lowest overall cost based on premiums and co-payments.

Enrolling in Part D

Medicare Part D is regulated the same as a Medicare Advantage Plan. The enrollment periods are the same. When starting Medicare. during AEP (Annual Enrollment Period) and OEP (Open Enrollment Period). You may also qualify for an SEP (Special Enrollment Period).

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