Medicare Part D Prescription Drug Plan

Medicare Part D – Prescription Drug Plan approved through Medicare

Anyone that has Medicare Part A and/or Medicare Part B is eligible for a Part D plan to help pay for brandname and generic medications that have been prescribed.

Part D of Medicare can be purchased as a stand – alone- drug plan seperately if a consumer only has Medicare Parts A & B or if they have a Medicare Supplement Plan for a monthly premium. You will pay your monthly premium to have the Part D plan, an annual Drug Deductible and copays(flat amount) or co-insurance (a percentage) for your medications that are prescribed. 

Medicare Part D plans can also be combined in a Medicare Advantage plan at a zero premium. With a Part D plan that is included you could have a drug deductible to meet annually as well as copays and/or co-insurance as well depending on the Carrier and the plan.

You can enroll up to three months before your birth month, the month of, and three months after your birth month of turning 65. You can change your plan during the annual enrollment period which runs from October 15 thru December 7 every year. 

CMS or Centers for Medicare and Medicaid Services also known as Medicare requires as of 2008 for anyone who is eligible for Part A and/or Part B to have a Part D of Medicare Prescription Drug plan. If they do not they will be penalized 1% of the National Drug Plan average for every month that they were entitled to it but didn’t get it and that is for life.

Important to know is that if your medication is not listed in the plans formulary then you won’t be able to get that medication. Your Doctors office can request a medical exception to be able to get the medication at a negotiated price for you even if it is not found on the formulary. A formulary is a list of the medications that a plan is able to provide to their members.

Beginning in 2025, the annual limit on out of pocket costs for Medicare Part D prescription costs will be $2000. The famous donut hole will be gone finally!!