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Prescription Drug Coverage (Medicare Part D)

Christian Worstell by Christian Worstell    |    Published Nov 25, 2019    |    Reviewed by John Krahnert

Original Medicare (Medicare Part A and Part B) does not cover prescription drugs. If you enroll in a Medicare Advantage plan (Medicare Part C), your plan may include prescription drug coverage.

If you’re enrolled in Original Medicare and need help paying for your medications, consider enrolling in a Medicare Part D (Medicare’s prescription drug plan).

Below, we explain more about Part D, including how and when to enroll.

You can compare Part D plans available where you live and enroll in a Medicare prescription drug plan online when you visit MyRxPlans.com.

Enroll in Medicare Part D at MyRxPlans.com.

Vist MyRxPlans.com

Part D Benefits 

With Medicare Part D, your prescription drug coverage will apply to a large list of prescription drugs. The list is split into tiers, depending on their prices. In general, drugs that lie in lower tiers are cheaper than those in upper tiers.

Your provider may be able to gain an exception for you, if he or she believes that you need to be treated with a drug in an upper tier.

Medicare Part D Costs 

For most Medicare Part D plans, prescription drug coverage will require that you pay a monthly premium.

However, your costs aren’t limited to premiums. Your out-of-pocket costs can include:

  • Annual deductibles
    An annual deductible is the amount you must spend each year before your Part D plan will begin paying its share.

    In general, Medicare Part D deductibles are limited to $435 for the year in 2020.

  • Copays
    For Part D plans, you may have to pay copays after you’ve met your deductible. These are often fixed charges (for example, $35 per brand-name prescription drug and $10 per generic prescription drug). 

  • Coinsurance
    Instead of copays, you may be required to pay a percentage of a prescription’s cost.

  • Coverage gap
    Medicare Part D’s coverage gap or “donut hole” begins after you and your plan have paid a certain amount for drugs. This figure is $4,020 in 2020.

    When you are in the coverage gap in 2020, you generally have to pay 25 percent of brand-name drug costs and generic drug costs.

Signing up for Medicare Part D

To find prescription drug coverage in your area, Medicare offers a convenient search tool. Using this tool, you can enter your zip code and compare different plans that are available.

To avoid a late enrollment penalty, you should sign up for a Medicare Part D plan during your IEP, or initial enrollment period. This period begins three months before you turn 65, includes the month of your birthday, and continues three months after your birthday.

You can compare Part D plans available where you live and enroll in a Medicare prescription drug plan online when you visit MyRxPlans.com.1

Enroll in Medicare Part D at MyRxPlans.com.

Vist MyRxPlans.com


 

Christian Worstell is a health care and policy writer for MedicareSupplement.com. He has written hundreds of articles helping people better understand their Medicare coverage options.

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