Prescription Drug Plans

Medicare drug plan can make changes to its formulary, it is imperative to review your coverage yearly.

Prescription Drug Plans (Part D)

Medicare Part D provides prescription drug coverage available to anyone enrolled in Part A and/or Part B. The covered medications is based on a list provided by Medicare and each plan must cover at least 2 drugs in every therapeutic class.

Private insurance companies provide their formulary where they classify medications into tiers with associated co-pays and/or co-insurance.

Part D Coverage can be obtained through a stand-alone plan (PDP) or through an advantage plan with prescription coverage (MA-PD).

Enrollment in Part D is required. If you are enrolled in both Part A and Part B and you don’t enroll in Part D, you may be subject to a penalty. This penalty is lifetime and can add up to a substantial amount.

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Phases of
Medicare Part D

Deductible Phase

Initial Coverage Phase

Catastrophic Coverage Phase

My clients get an annual review to make sure their plan fits their needs.

Faq's

Explore common questions about Part D Plans and how we can help you.

Can I switch plans if I get put on a new medication that isn’t covered by my current plan?
You don’t need to switch plans when your doctor prescribes a new medication. All plans have to cover 2 medications that are used to treat each condition. If the medication you need is not covered, your doctor can always request a formulary exception to get it covered.
Once you are enrolled in Part A & B, you need to be enrolled in a drug plan, otherwise you will incur a penalty. The penalty is calculated from the time you were eligible for a plan until you actually enroll. This penalty is not a one time penalty – but a lifetime penalty.

If your union plan is a one that is considered credible by Medicare you should not have to enroll in another plan. Contact your employer to determine about the coverage provided.

If you use the VA to get your medications, it is considered credible coverage and you do not to enroll in a Medicare Plan. If you were to enroll in a Part D plan at a later date, you will not be subject to a late penalty.  You will need to provide proof that you were enrolled in VA benefits.
You can switch drug plans during Annual Open Enrollment, which happens every October 15th – December 7th. There could be a circumstance which makes you eligible for a special election, so reach out to see if one is available to you.

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Medicare

Medicare is a federal health insurance program for people aged 65 or older and certain younger individuals.

Medicare Advantage Plans

Medicare is a federal health insurance program for people aged 65 or older and certain younger individuals.

Medicare Supplement Insurance

Medicare is a federal health insurance program for people aged 65 or older and certain younger individuals.

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