Prescription drug coverage is one of the most important pieces of the Medicare puzzle. That’s where Medicare Part D comes in. Offered through private insurance companies, Part D helps cover the cost of prescription medications, which Original Medicare (Parts A and B) does not.
Each Part D plan has a formulary, or list of covered drugs, organized into tiers based on cost. Lower tiers typically include generic medications, while higher tiers include brand-name or specialty drugs. It’s important to choose a plan that covers the medications you take regularly.
Part D plans also come with a network of pharmacies, so you’ll want to check whether your preferred pharmacy is included. Some plans offer mail-order options, which can be more convenient and cost-effective.
Part D coverage includes four phases:
-
Deductible phase – You pay out of pocket until the deductible is met.
-
Initial coverage – You pay a portion of the drug cost, and the plan pays the rest.
-
Coverage gap (donut hole) – Your share of costs may increase temporarily.
-
Catastrophic coverage – Once your out-of-pocket costs reach a certain limit, you pay much less.
Choosing the right Part D plan means balancing cost, coverage, and convenience. Let us help you find a plan that fits your health and budget needs.