Plan My Coverage

Exclusive Benefits

Coverage
Offered by private health insurance companies, Medicare Part D covers the prescription drug costs for medications covered under Medicare. You can opt for this coverage in addition to:
- Original Medicare Plan, i.e. Part A and Part B, or
- Original Medicare Plan with a Medigap Plan
Eligibility
The eligibility criteria for Medicare Part D is similar to the Original Medicare Plan. You can enroll for Prescription Drug Coverage if you are:
- 65 years of age or older.
- Terminally ill with certain diseases, such as kidney failure.
- Younger than 65 years, but have certain disabilities.
Limitations
There are 2 major limitations to Medicare Part D:
- Most Part D plans have ‘formularies,’ i.e. lists of covered prescription drugs. This means that the cost of medications not mentioned in the formularies will not be covered under this part.
- Part D plans will have networks of approved pharmacies in your area.
Considerations
Here’s a list of considerations regarding Prescription Drug Coverage:
- Part D plan costs can vary. It’s best to choose a plan that meets your needs and budget.
- Insurance premiums for Part D might change every year. You will be notified of these changes in the fall, prior to the annual Open Enrollment Period.
- Medicare Part D offers a low-income subsidy program. Medicare beneficiaries may qualify for financial assistance with the cost of their medications basis their assets and income.

Costs Information

Premium

Most plans require a monthly premium.

Many Part D plans require you to pay a fixed copayment each time you fill a prescription.

Certain plans have deductibles.

Some Part D plans require that you pay a percentage of a medication’s cost as coinsurance, each time you fill a prescription.