Part D – Prescription Drugs
Medicare Basics Video
What Medicare Part D drug plans cover?
All plans must cover a wide range of prescription drugs; including most drugs in certain classes, such a drugs to treat cancer, diabetes or HIV/AIDS. A plans formulary is a list of covered drug and each plan has its own formulary. There are different levels (tiers) on the formularies. Drugs in each tier have a different cost. For example, a drug in a lower tier will generally cost you less than a drug in a higher tier.
How to get prescription drug coverage?
Medicare drug coverage helps pay for prescription drugs you need. It’s optional and offered to everyone with Medicare. Even if you don’t take prescription drugs now, consider getting Medicare drug coverage. If you decide not to get it when you’re first eligible, and you don’t have other creditable prescription drug coverage (like drug coverage from an employer or union) or get Extra Help, you’ll likely pay a late enrollment penalty if you join a plan later. Generally, you’ll pay this penalty for as long as you have Medicare drug coverage.
To get Part D coverage, you must join a Medicare-approved plan that offers drug coverage. Each plan can vary in cost and specific drugs covered.
There are 2 ways to get Part D coverage:
1. Medicare drug plans.
These plans add drug coverage to Original Medicare, some Medicare Cost Plans, some Private Fee‑for‑Service plans, and Medical Savings Account plans. You must have Medicare Part A and/or Medicare Part B to join a separate Medicare drug plan
2. Medicare Advantage Plan (Part C)
You can join a Medicare Health Plan with drug coverage. You get all of your Part A, Part B, and drug coverage, through these plans. You must have Part A and Part B to join a Medicare Advantage Plan, and not all of these plans offer drug coverage.
To join a Medicare drug plan, Medicare Advantage Plan, or other Medicare health plan with drug coverage, you must be a United States citizen or lawfully present in the United States.
Part D late enrollment penalty
The late enrollment penalty is an amount that’s permanently added to your Medicare drug coverage (Part D) premium. You may have to pay a late enrollment penalty if at any time after your Initial Enrollment Period is over, there’s a period of 63 or more days in a row when you don’t have Medicare drug coverage or other creditable prescription drug coverage