FAQ

Medicare Part D is a prescription drug plan that helps cover the cost of prescription medications. It is available to those who are eligible for Medicare and can be added to Original Medicare, some Medicare Cost Plans, and Medicare Medical Savings Account Plans.

You can enroll in a Medicare Part D plan during your Initial Enrollment Period when you first become eligible for Medicare or during the Annual Enrollment Period from October 15 to December 7 each year. You can enroll through Medicare’s website, by calling Medicare, or by working with an insurance broker.

Medicare Part D is a standalone prescription drug plan that works with Original Medicare, while Medicare Advantage Prescription Drug Plans (MAPD) are Medicare Advantage plans that include both health coverage and prescription drug coverage within the same plan.
Costs for Medicare drug plans can include a monthly premium, an annual deductible, copayments or coinsurance for each prescription, and potentially higher costs in the coverage gap (donut hole). The specific amounts vary by plan.
The coverage gap, or donut hole, is a temporary limit on what Medicare will pay for prescription drugs. After you and your plan have spent a certain amount on covered drugs, you enter the gap, where you may pay higher costs until you reach the out-of-pocket limit, after which catastrophic coverage kicks in.
To choose the best plan, consider factors like the medications you take, each plan’s formulary (list of covered drugs), monthly premiums, copayments, and the pharmacy network. You can use the Medicare Plan Finder tool to compare plans or consult with a licensed insurance agent.
If you don’t enroll in a Medicare Drug Plan when you’re first eligible and don’t have other creditable prescription drug coverage, you may have to pay a late enrollment penalty if you decide to join later. This penalty is added to your monthly premium for as long as you have the plan.
Yes, you can change your Medicare Drug Plan during the Annual Enrollment Period (October 15 to December 7). You may also qualify for a Special Enrollment Period if you have certain life events, such as moving out of your plan’s service area or losing other prescription drug coverage.

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