Medicare Prescription Drug Plan (Part D)

Posted:July 6, 2015

Medicare Prescription Drug Plan (Part D) is the plan through Medicare that is responsible for payment of prescription medicine. Part D Plans are available through independent insurance companies and can vary in premiums, deductibles, co-payments, costs in the coverage gap, and prescriptions covered.  Some Part D plans do not have a deductible; however, if your plan does it cannot be more than $320 for 2015. The coverage gap better known as the “donut hole,” happens once you and your plan have spent $2,960 on covered drugs. Once you have reached this amount you are responsible for 45% of brand-name drugs and 65% of generic drugs until your out-of-pocket cost reaches $4,700. At this stage you will have entered catastrophic coverage. This stage ensures that you pay a small copayment amount for the remainder of the year.

The list of prescriptions covered that is unique to each Part D Plan is called a Formulary. On the formulary drugs are categorized in Tiers (1, 2, 3, etc.). A lower tier drug will generally cost less.

There are two ways to get Medicare prescription coverage: either by adding a Medicare Prescription Drug Plan (Part D) to Original Medicare or getting a Medicare Advantage Plan (Part C) that offers Medicare Prescription coverage. You can only have one Part D plan, this means if you enroll in a drug plan through a Medicare Advantage Plan and a Part D plan through Medicare you will be disenrolled from your Medicare Advantage Plan and placed back in original Medicare.

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*** The prices listed above reflect the 2015 calendar year and are subject to change. ***