Overview
Original Medicare doesn't cover most prescriptions. And Medicare Supplements don't cover them at all. So most people have to purchase a Medicare Part D plan separately to cover their medications.
Part D plans are administered by private insurance companies and they vary in cost and covered drugs from company to company. Part D members will pay a copayment for their prescriptions. There are a few unique features of Part D that beneficiaries need to understand
MEDICARE PART D: PRESCRIPTION DRUG COVERAGE
Additional Information
Part D coverage involves four distinct phases:
1. Initial Deductible Phase: In this phase, Medicare recipients are responsible for paying the full cost of their prescriptions until they reach their out-of-pocket deductible amount.
2. Initial Coverage Phase: After reaching the deductible, enrollees are typically responsible for a copayment or coinsurance amount for their prescriptions.
3. Coverage Gap or Donut Hole: Once enrollees reach their annual out-of-pocket spending limit for prescription drugs, they will enter the Coverage Gap phase. During this phase, enrollees will pay a higher coinsurance rate or copayment amount for generic and brand name drugs.
4. Catastrophic Coverage Phase: Once enrollees have spent a certain amount out-of-pocket they will enter the catastrophic coverage phase. At this point, enrollees will typically pay a very small amount out-of-pocket to cover their prescriptions.
You can obtain Part D Prescription drug coverage by:
1) Enrolling in a stand-alone Part D plan. You will pair your Part D plan alongside Original Medicare & a Medicare Supplement.
2) Enrolling in a Part C Medicare Advantage plan. Most Medicare Advantage plans INCLUDE Part D drug coverage at no additional cost.
3) Enrolling in a Medicare Savings Account (MSA). An MSA is a healthcare savings account combined with a supplemental Medicare plan that provides prescription drug coverage.
