Prescription Drug Plans
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.
Get Help With Medicare, Or Learn More
Phases of
Medicare Part D
Deductible Phase
- The deductible is $590 for 2025
- You will pay 100% of the cost of the medication until you meet this deductible
- Plans generally only apply the deductible to Tiers 3, 4 & 5
Initial Coverage Phase
- Once the deductible is met, you will pay the co-pay or co-insurance set by the plan and your plan covers the rest of the cost.
Catastrophic Coverage Phase
- Starting in 2025 there is a spending cap of $2,000 for out of pocket costs.
- Once you have spent $2,000 on covered medications you will pay nothing for the rest of the year.
- Out of pocket costs are only for medications that are covered in the plan and does not include the plan’s premium.
My clients get an annual review to make sure their plan fits their needs.
- Medicare drug plans make changes to its formulary, so it is imperative to review your coverage yearly.
- Coverage can only be changed during Annual Enrollment Period (Oct 15-Dec 7) or if you qualify for any Special Election Period.
- You can use the Medicare Plan Finder tool by going to medicare.gov to compare plans.
Can I switch plans if I get put on a new medication that isn’t covered by my current plan?
Do I need a drug plan even if I don’t take any medications?
What if I am retired and my union provider drug coverage?
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.
What if I have VA coverage?
When can I switch plans?
Client Testimonials
Read what our satisfied clients have to say about their experience with 65+ Insurance Solutions. Don’t just take our word for it – hear it from our valued clients!
Learn More
About The Products
& Services We Provide
Medicare
Medicare Advantage Plans
Medicare Supplement Insurance
Learn More About Medicare
If you’re looking for an affordable Medicare Plan with the best coverage it’s time to speak with me.
Frequently Asked Questions
Check out some frequently asked questions from other our customers and find the information you need about our company, location and services.