Medicare Part D – How to obtain Part D Drug Coverage

There are 2 ways to obtain drug coverage through Medicare:

• Medicare Prescription Drug Plan (Part D). These plans (sometimes called “PDPs”) add drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private Fee-for-Service (PFFS) Plans, and Medicare Medical Savings Account (MSA) Plans.
• Medicare Advantage Plan (Part C) (like an HMO or PPO) or other Medicare health plan that offers Medicare prescription drug coverage. You get all of your Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage, and prescription drug coverage (Part D), through these plans. Medicare Advantage Plans with prescription drug coverage are sometimes called “MA-PDs.” You must have Part A and Part B to join a Medicare Advantage Plan.

Premium for Part D Drug Coverage

If you belong to a Medicare Advantage Plan (Part C) or a Medicare Cost Plan that includes Medicare prescription drug coverage, the monthly premium you pay to your plan may include an amount for drug coverage. If you have a Medigap (Medicare Supplement) policy, you may be required to purchase a stand-alone drug plan separately.

Which drugs are covered under my Part D Drug Coverage?
Like most insurance plans, Part D Drug plans whether stand-alone or part of a Medicare Advantage plan, have a prescription drug formulary. A Formulary is a list of medications that are covered on a plan. These list show if and how a medication is covered. Generally, these lists have tier levels for the covered medications which identify the insureds responsibility (copay or coinsurance) for the medication in question. Make sure that your medications are covered by checking the plan formulary before enrolling.