Medicare Part D – Prescription Drug Plans

Medicare Part D helps you manage the cost of prescription medications by offering insurance for outpatient drugs. These plans are available through private insurance companies approved by Medicare, and they can be added to Original Medicare or some Medicare Advantage plans that do not already include drug coverage.

How Does Medicare Part D Work?

Each Medicare Part D plan has a formulary, which is a list of covered medications. These drugs are organized into different “tiers,” with lower-tier drugs typically having lower copayments. Your out-of-pocket costs will depend on the tier of your prescribed medication.

The Coverage Gap (Donut Hole)

Medicare Part D has historically included a coverage gap, known as the “donut hole,” where beneficiaries temporarily pay a larger share of their drug costs. However, recent changes have helped close this gap, significantly reducing the out-of-pocket expenses for most people.

Costs and Enrollment

Premiums for Part D plans vary depending on the provider and the level of coverage offered. Additionally, beneficiaries may face a deductible, copayments, or coinsurance based on the medication tier. If you do not enroll in Part D when first eligible and do not have other creditable drug coverage, you could face a late enrollment penalty that increases the longer you delay.

Recent Changes to Medicare Part D

Starting in 2025, Medicare will introduce a $2,000 annual out-of-pocket cap on prescription drug costs, providing significant relief to those with high medication expenses. Additionally, beneficiaries will have the option to spread their drug costs over monthly payments, improving affordability. Explore Medicare Part D Plans and find the one that best fits your needs. Need assistance? Contact Dawn Watson to enroll and ensure you have the right coverage.