Understanding Medicare Part D

Medicare Part D provides prescription drug coverage through Medicare-approved private insurance companies. You can get Part D through a standalone prescription drug plan with Original Medicare or through many Medicare Advantage plans that include drug coverage.

Key Things to Know

💊 Prescription Coverage

Part D helps cover the cost of many generic and brand-name prescription medications. Each plan has its own list of covered drugs, called a formulary.

📋 Check Your Medications

Before choosing a plan, make sure your prescriptions are covered and compare:

• Your medications

• Drug tiers

• Co-pays or coinsurance

• Preferred pharmacies

• Deductibles

• Monthly premiums

A drug covered by one plan may have different costs,or may not be covered by another plan.

💰 Understand Your Costs

Depending on the plan, you may pay:

• Monthly premium

• Annual deductible

• Co-payments or coinsurance

For 2027, covered Part D prescription drug costs are capped at $2,400 in annual out-of-pocket spending. Once you reach that limit, you pay $0 for covered Part D drugs for the remainder of the calendar year.

⚠️ Don't Overlook the Late Enrollment Penalty

If you don't enroll in Part D when first eligible and go 63 days or more without Part D or other creditable prescription drug coverage, you may have to pay a late enrollment penalty when you enroll later. The penalty generally continues for as long as you have Medicare drug coverage.

What Should You Compare?

When reviewing Part D plans, consider:

• Are all my prescriptions covered?

• What tier is each medication on?

• What will I pay at the pharmacy?

• Is my preferred pharmacy in-network?

• What is the plan's premium and deductible?

• Will my costs change if my prescriptions change?

Need Help Comparing Part D Plans?

Choosing a prescription drug plan isn't just about finding the lowest premium. Your medications, pharmacies, drug tiers, and expected costs all matter. As a licensed local insurance agent, I can help you compare available Part D options and review your medications to help you understand your coverage choices.

Call 330-716-1368 for a no-cost, no-obligation Medicare consultation.

Plan availability, premiums, formularies, pharmacies, benefits, and costs vary by plan and service area. We do not offer every plan available in your area.