Medicare Part D

Medicare’s Prescription Drug Plan (PDP) program – Part D – is optional.

However, if you do not enroll in a PDP when you become eligible, you may be charged a late enrollment penalty if you decide you want this coverage later.

Criteria for joining a Prescription Drug Program are:

  • Must have Part A and Part B coverage
  • Live in the plan service area
  • Live within the United States

Prescription Drug Plan coverage is also available to you as a stand-alone Part D plan, which can be added to your Original Medicare coverage.

Read more about Medicare Part D:

Medicare Part D FAQ’s

Why Medicare Part D?

According to the Kaiser Family Foundation, prescription drugs are a part of the care plan for 59 million seniors and people with disabilities. What’s more, the drugs account for $1 of every $6 in Medicare spending.Private companies offer Part D plans in...

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How Medicare Part D Works

We suggest you select a PDP when you are eligible, even if you do not currently take any prescription medications. There are two reasons:If you fail to sign up for Medicare prescription drug coverage when you first become eligible, unless you have what...

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Common Medicare Part D Terms

Formulary A formulary is a list of medications list of medications covered by a prescription drug plan. It usually includes tiers, or levels, of coverage based on how much the drugs cost. In general, the higher the drug price, the more the plan member must...

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Medicare Part D Coverage Gap (Donut Hole)

This term refers to the gap in coverage by prescription drug plans that occurs when the member and the plan have each contributed a set amount outlined in the plan for the medications that it covers. Some people will not experience the gap because the...

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When can I enroll in a Part D prescription drug plan?

If you need to enroll in Part D for the first time, you can do so during your IEP, during Fall Open Enrollment (see What is Fall Open Enrollment?), or if you qualify for a Special Enrollment Period (see What Other Opportunities Do I Have To Change My...

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What is the Extra Help Special Enrollment Period (SEP)?

If you have Extra Help, the federal program that helps pay for the out-of-pocket costs of Medicare prescription drug coverage, you have access to an SEP to enroll in a Part D plan or switch between plans.This SEP is available once per calendar quarter for...

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How Does Medicare Cover Prescription Drugs?

Part A covers the drugs you need during a Medicare-covered stay in a hospital or skilled nursing facility (SNF).Note: If you are getting SNF care that is not covered by Part A, your drugs may be covered by Part D.Part B covers most drugs administered by...

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How Does Medicare Cover Injectable Drugs?

Part B covers an injectable drug if it generally cannot usually be self-administered and your doctor provides and administers the drug to you.Original Medicare covers these outpatient drugs at 80% of its approved amount, meaning that as long as you see a...

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Are Vaccines Covered by Medicare Part B or Part D?

Part D covers most vaccines that your doctor recommends you get. The only exceptions are the flu, pneumonia, and hepatitis B vaccines, and certain vaccines that you receive after being exposed to a dangerous virus or disease (see below). Part D plans must...

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How is insulin covered by Medicare?

The way Medicare covers your insulin depends on how you take insulin.Part D may cover insulin and related medical supplies used to inject insulin (syringes, gauze, and alcohol swabs) if you have a prescription from your doctor. Your drug plan should cover...

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