Know more about my Medicare options

Prescription Drug Coverage: Is a Part D Plan the Right Choice for You?

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Taking your medication is an important part of staying healthy as you age. But sometimes, the costs of these drugs can be high, and pharmacy costs may change when you transition to Medicare.

There are certain health plans, like Part D drug plans, that can help you save money on your prescriptions. These plans work with the other parts of Medicare to give you more complete coverage and help you pay less at your pharmacy.

How Do I Get My Prescriptions Covered?

There are two ways to get prescription drug coverage through Medicare.

  1. If you’re eligible for Part A and B coverage (Original Medicare), you can choose a standalone Part D prescription drug plan from a private insurance company.
    • You’ll pay your premiums for Part B coverage plus your premiums for Part D coverage.
    • You’ll enroll separately and receive a specific prescription drug plan card to use at your pharmacy.
  1. You can choose a Part C plan (Medicare Advantage plan) from a private insurance company that includes prescription drug coverage along with coverage for Parts A and B and additional benefits.
    • You’ll typically receive one shared card to use at your doctor’s office and pharmacy.
    • You’ll pay your premiums for Part B coverage plus your premiums for Part C coverage.

Are the extra benefits, like vision coverage or a gym membership, important to you? Do you like the idea of having all-in-one Medicare coverage?

  • If you answered yes to either question, Part C may be the best way to get prescription drug coverage.
  • If you are happy with your current Medicare benefits and only need to add prescription drug coverage, a standalone Part D plan could meet your needs.

How Do I Choose a Part D Plan?

When searching for a Part D drug plan, consider the following questions:

  • Are the drugs I need covered under this plan?
  • Do your research! Each plan lists the names of the drugs it covers. This is called a formulary. You can request this list from the plan. Don’t forget to look for the generic versions of your brand name prescriptions. If you find that your medications are not covered, you can review the list with your doctor to see if there is a covered medication that will work for you.
  • How much are copays for prescriptions I need?
  • Once you know if the medications you need are covered, you should check the cost for these medications. You’ll want to make sure the copay – the fee you pay when you fill the prescription – works within your budget under the plan you are considering.
  • Is my pharmacy covered?
  • Check to see if your preferred pharmacy is in the service area of the Part D drug plan you are considering. This may not be as important of a factor, but if you live in a rural area or you have used the same pharmacy for years, you may not want to switch.

You aren’t required to enroll in a Part D plan. But without some sort of prescription drug coverage, you are responsible for all of your prescription medication costs. Part D plans can help keep prescription drug costs predictable.

If you have limited resources and income, you may also be eligible for Extra Help through Social Security. Extra Help provides assistance with monthly premiums, deductibles, and copays. Visit www.ssa.gov/benefits/medicare/prescriptionhelp/ to see if you qualify.

Learn more about the parts of Medicare and other solutions, like Medicare Supplement insurance, to see if you can get the health care you need for a better value under Medicare!

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