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Medicare Part D (Prescription Drug Coverage)
U.S. Centers for Medicare & Medicaid Services
Medicare drug coverage (Part D) helps pay for the brand-name and generic prescription drugs Medicare beneficiaries need. It is optional and is offered to everyone with Medicare by insurance companies and other private companies approved by Medicare. Beneficiaries can get Part D either as a stand-alone Prescription Drug Plan (PDP) added to Original Medicare, or bundled into a Medicare Advantage plan (MAPD). Each plan has its own formulary (list of covered drugs) and pharmacy network. Beneficiaries who do not enroll when first eligible and do not have other creditable drug coverage may owe a late enrollment penalty if they join later. Low-income beneficiaries may qualify for Extra Help (Low-Income Subsidy) to lower or eliminate premiums and copays.
Who qualifies
Anyone enrolled in Medicare Part A or Part B. To enroll in a stand-alone PDP you must have Part A and/or Part B; to enroll in a Medicare Advantage drug plan (MAPD) you must have both Part A and Part B and live in the plan's service area.
What it covers
Coverage for prescription drugs on the plan's formulary. Cost protections include a deductible cap, standard coinsurance/copay tiers, and (per recent Medicare changes) an annual out-of-pocket cap on covered drug spending.
Cost
Plan-specific premiums, deductibles, and cost-sharing. Beneficiaries enrolling without creditable drug coverage 63+ days after first eligibility may owe a permanent late enrollment penalty added to premiums. Extra Help / Low-Income Subsidy can eliminate or reduce premiums and copays for qualifying low-income beneficiaries.
How to apply
Compare and enroll in Part D plans on Medicare.gov Plan Finder, by calling 1-800-MEDICARE, or with free help from SHIBA in Washington. Initial Enrollment Period is the 7-month window around Medicare eligibility; Annual Open Enrollment runs October 15 to December 7.
Source www.medicare.gov/health-drug-plans/part-d