Medicare Part D

Except for certain situations, you should enroll in Part D when you first become eligible to avoid penalties.

Part D was designed to aid people with Medicare, lower their prescription drug costs and to protect against future costs. This prescription drug plan will allow you to have access to medically necessary drugs. Keep in mind Part D plans have a coverage gap (or the “donut-hole”).

The coverage gap begins after you and your drug plan have spent a certain amount for covered drugs. Once you and your plan have spent a specific amount on covered drugs, you're in the coverage gap and will have to pay all costs out-of-pocket for your drugs up to a limit. This amount changes each year. Also, people with Medicare who get Extra Help paying Part D costs won’t enter the coverage gap.

Your yearly deductible, your co-insurance or copayments, and what you pay in the coverage gap all count towards this out-of-pocket limit. The limit doesn’t include the drug plan’s premium. Over the counter medicines are not covered by Medicare Part D.

You should review your Prescription Drug coverage every year.

Your actual drug plan costs will vary depending on:

  • The drugs you use
  • The plan you choose
  • Whether you go to a pharmacy in your plan's network
  • Whether the drugs you use are on your plan's formulary
  • Whether you get extra help paying your Medicare Part D costs