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Medicare Drug Plan

About Medicare Prescription Drug Coverage

Medicare's prescription drug coverage (also called Part D) is a program to help people on Medicare pay for medicine. You can add Part D to Original Medicare. It can also be added to certain other Medicare plans. You can also get prescription drug coverage by enrolling in a Medicare Advantage Plan that offers it.

Eligibility

Most people who are 65 years and older or are disabled can enroll in Medicare. This includes Medicare drug plans.

When to Enroll

You can enroll in Medicare 3 months before your 65th birthday or 3 months after. People who are disabled can enroll during a 7 month window around their 25th month of disability. Medicare also has an open enrollment period from October 15 through December 7.

What it Covers

Private health insurance companies manage the drug plans for Medicare. They provide a list of brand name and generic drugs that they cover. The list can change over time. It is common for drug plans to exclude more expensive brand name medications when a generic one can be found. However, if there is a medicine that you really need, your doctor may be able to appeal and get it covered.

What it Costs

The costs depends on many things, such as the medicines you use, the plan, and whether you go to a pharmacy in your plan’s network. Here are some costs you can expect to pay:

Ways to Lower the Cost

There are steps that you can take to lower your costs, such as:

Making the Decision

By answering a few questions, you should be able to choose a plan that works best for you:

Where to Find Out More

Visit the US Medicare website to learn more about their health plans and drug coverage. If you are eligible, you can even sign up for Part D online.

RESOURCES:

Medicare
https://www.medicare.gov

Social Security Administration
https://www.ssa.gov

REFERENCES:

Drug coverage (Part D). Medicare website. Available at: https://www.medicare.gov/drug-coverage-part-d. Accessed October 19, 2021.

Enrolling at the right time. AARP website. Available at: http://www.aarp.org/health/medicare-insurance/info-04-2011/medicare-enrollment.html. Accessed October 19, 2021.

Extra help with Medicare prescription drug plan costs. Medicare website. Available at: https://secure.ssa.gov/i1020/start. Accessed October 19, 2021.

Get help paying costs. Medicare website. Available at: https://www.medicare.gov/your-medicare-costs/get-help-paying-costs. Accessed October 19, 2021.

Medicare Advantage plans. Available at: https://www.medicare.gov/sign-up-change-plans/types-of-medicare-health-plans/medicare-advantage-plans. Accessed October 19, 2021.

Medicare and you: 2022. Medicare website. Available at: https://www.medicare.gov/Pubs/pdf/10050-Medicare-and-You.pdf. Accessed October 19, 2021.

Last reviewed October 2021 by EBSCO Medical Review Board  Last Updated: 10/19/2021