Understanding Medicare Part D: Prescription Drug Coverage
Medicare Part D provides prescription drug coverage to anyone with Medicare and is offered through private insurance companies approved by Medicare.
You can get Part D coverage in one of two ways:
-
By enrolling in a standalone Part D plan (typically used with Original Medicare and Medigap) or
-
Through a Medicare Advantage Plan that includes drug coverage (MAPD).
​
Each plan has its own formulary (list of covered drugs), premium, deductible, and copayment amounts. It’s important to compare plans each year, as drug formularies and costs may change annually. Most plans group drugs into tiers, which affect your out-of-pocket costs.
​
​
​
​
Late Enrollment Penalty Warning
If you do not enroll in a Part D plan when you first become eligible (and you don’t have other creditable drug coverage, like from an employer or union), you may face a late enrollment penalty.
This penalty is added to your monthly Part D premium for as long as you have Medicare, and it increases the longer you go without coverage. The penalty is calculated based on the number of months you were eligible but didn't enroll and can significantly impact your Social Security check, as Part D premiums are often deducted directly.
​
Summary
Medicare Part D is essential if you rely on prescription medications—or even if you don’t now but may in the future. Not enrolling when first eligible, without other creditable coverage, could cost you more over time due to penalties.
For those on Original Medicare with a Medigap plan, enrolling in a standalone Part D plan ensures you’re covered. For Medicare Advantage members, be sure to choose a plan that includes drug coverage (MAPD) if needed.
Comparing plans based on your medications and preferred pharmacy can help you find the best value each year.
​
​​
​
​
​
General disclaimers
This website is operated by MediLife & Health, LLC. Nothing contained herein constitutes nor is intended to constitute an offer, inducement, promise, or contract of any kind, or a recommendation to purchase insurance from any particular insurance company at any particular level of benefits or plan design. MediLife & Health, LLC is not an insurance company. In offering this website, MediLife & Health, LLC is required to comply with all applicable federal laws, including the standards established under 45 CFR 155.220(c) and (d) and standards established under 45 CFR 155.260 to protect the privacy and security of personally identifiable information. MediLife & Health, LLC intends that the general and insurance specific information contained on this web site be accurate and reliable, however, MediLife & Health, LLC makes no warrantees or representations as to the completeness, accuracy or timeliness of the web site materials. The company will not be liable for any damages of any kind from or relating to the use of, or reliance upon, results obtained by users from the web site and related services.
​
The benefits mentioned are Special Supplemental Benefits for the Chronically Ill (SSBCI). You may qualify for SSBCI if you have a high risk for hospitalization and require intensive care coordination to manage chronic conditions such as Chronic Kidney Diseases, Chronic Lung Disorders, Cardiovascular Disorders, Chronic Heart Failure, or Diabetes. For a full list of chronic conditions or to learn more about other eligibility requirements needed to qualify for SSBCI benefits, please refer to Chapter 4 in the plan’s Evidence of Coverage.
​
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1–800–MEDICARE (TTY users should call 1-877-486-2048) 24 hours a day/7 days a week to get information on all of your options.
​
Medicare Disclaimers | Privacy Policy​​​​​​​​​​​​​​​
