Medicare Part D

Medicare Part D is an optional coverage plan for anyone covered by Medicare Part A, B, and C. In short, Part D plans offer prescription drug coverage depending on the provider and payment plan you choose.

What does Medicare Part D cover?

There are four tiers, or formularies, that cover various prescription drugs. Each tier is offered at a different rate proportionate to the offered coverage. These tiers include:

Tier 1: Low Copayment, Covers Generic Prescription Drugs
Tier 2: Slightly Higher Copayment, Covers Brand Name, Preferred Drugs
Tier 3: Higher Copayment, Covers Non-Preferred, Brand Name Drugs
Tier 4: Specialty Tier: Highest Copayment, Covers Very High-Cost Drugs

There are, of course, exceptions to these tiers in terms of insurance needs, budgets, and plan providers. When looking for the right Part D plan to fit your needs, be sure to investigate what is offered and at what cost.

If you sign up for a plan and find that it does not cover a medication you need, you have options:

You should firstly contact your plan provider and ask why and if there are any exceptions.
You can pay for the drug yourself (ask your provider if this will count towards your out-of-pocket costs).
Talk to your doctor to see if there are alternatives available in your plan.

Plans may limit the number of prescription drugs that are covered for safety purposes. Part D also covers injections and vaccines used for preventing illness.

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How much does Medicare Part D cost?

Part D costs are dependent on the plan provider. Payments are connected to the tier or formulary attached to the plan you choose. There are, however, categories of payment types you should be aware of:

Premium: Most Receivers of Part D only pay a monthly premium. If Medicare Part C also covers you, this premium may already be included/covered. If you want this premium deducted from your social security benefits automatically, you should contact your Part D provider.
Deductible: This fee is paid yearly and varies between plans, and some plans do not have a deductible. As of 2020, yearly deductibles are not allowed to be more than $435.
Copayment/Coinsurance: Each drug you purchase will likely have either a copayment (a set fee) or coinsurance (a percentage fee) dependent on your plan provider and tier you are covered by.

Searching for the best Medicare Part D coverage? Call Today!

If you are looking for Part D coverage, your search is over. To sign up for a plan or more information, call Medicare Strategist at (912) 412-0244.