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Understanding Medicare Part D


If you are
Medicare-eligible , you may find that navigating Medicare can be tricky. Now that the Annual Enrollment period is here, you may have started researching your options and coverage under Medicare. Your first step when signing up for Medicare is to see what plans you qualify for based on your state and income.

When deciding on the right Medicare plan for you, it’s important to look for what you need and want from your healthcare, whether that’s a focus on preventative care, or a plan that ensures your current medication regimen is continued.

Prescription Coverage

If you require access to consistent prescription medication you’ll need a plan that covers prescriptions. That’s where Medicare Part D plans come in. Part D plans offer prescription drug coverage to help ease the out-of-pocket costs of prescription medication.

Individuals covered under Medicare Part A and/or Part B plans are eligible for Part D plans regardless of income. Each Part D plan covers different drugs, so it’s important that you are signing up for a plan that covers the medication you need.

Part D Plans

So what do Medicare Part D plans look like? Most plans will have a monthly premium that varies from plan to plan, an annual deductible (exceeding no more than $405 as of 2018) and a co pay. Co pays are generally determined based on what “tier” the particular prescriptions falls under.

Most plans have tiers broken into Tier 1: lowest copay for generics, Tier 2: medium copay for preferred, brand-name drugs, Tiers 3: higher copay for non-preferred, brand-name drugs and the Specialty Tier: highest copay for very high-cost drugs.

Often, the same medication will vary in price based on what Part D plan you sign up for. Be sure to compare the plans you qualify for closely to determine which plan would best suit your needs and budget. The Annual Enrollment Period for Medicare Part D plans is from Oct. 15 to Dec. 7, unless you qualify for a Special Enrollment Period (SEP).

Need some expert guidance when making your final decision on Medicare Part D? As a private exchange, GoMedicare allows you to compare thousands of health plans from top carriers in your area, and unlike other exchanges, our licensed insurance agents are standing by to guide you through the enrollment process.

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