Medicare Part D

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WHAT IS MEDICARE PART D

Medicare Part D is an optional, privately run insurance program that helps Medicare beneficiaries pay for brand-name and generic prescription drugs. Available to everyone with Medicare, it covers outpatient prescription medication through stand-alone plans or as part of some Medicare Advantage Plans.

  • How it works:

    It is offered through private insurance companies approved by Medicare, not directly by the federal government.

  • Coverage:

    Plans cover a wide range of prescription drugs.
    Each plan has a “formulary,” which is a list of covered drugs.

  • Costs:

    Costs vary by plan but typically include a monthly premium, deductibles, and co-pays.

  • Penalty:

    If you do not join a plan when first eligible and do not have other “creditable” prescription coverage (like from a former employer), you may face a late enrollment penalty.

  • Enrollment:

    You can enroll in a stand-alone Prescription Drug Plan (PDP) to go with Original Medicare (Part A and/or B) or choose a Medicare Advantage Plan that includes drug coverage.
    Most people can join when turning 65 or using specific “Election” periods.

  • Extra Help:

    People with limited income and resources may qualify for a program called "Extra Help" to help pay for premiums, deductibles, and copayments.