Medicare Prescription Drug Plans (Part D)  

Senior woman with medication, reviewing

Original Medicare (Parts A and B) does not cover prescription drugs (those you buy in a pharmacy). Therefore every Medicare beneficiary should have a separate Prescription Drug Plan (Part D). Those plans are offered through private insurance companies, like Humana, Silverscript, United Healthcare etc.

All the plans have to meet certain requirements, however they can differ considerably in regards to their formularies (the drug lists) and in the coverage.  They also vary in monthly premiums (the lowest premium plan in the Chicago area is $7.30, the highest is $147.80 per month (for year 2021). 

Before you purchase a Prescription Drug Plan you should find out how much you will pay for your medications with a particular plan. We provide such drug analysis to our clients- so that you will know the costs of your medications and your premiums for the entire calendar year.

You should also buy a Prescription Drug Plan when you are first eligible (when you first enroll in Medicare). If you don't have a Prescription Drug Plan or other creditable coverage and you were Medicare eligible you may owe a late enrollment penalty. You cannot obtain a PDP plan at any time! Besides your Initial Enrolment Period (when you're first eligible for Medicare) you can get a PDP plan when you lose your employer coverage (you only have 2 months after the end date of coverage), and in a few specific cases. Please call our agency for more details.

Prescription Drug Plans can be changed every year during the Annual Enrollment Period (from October 15th to December 7th) and under special circumstances (for example when you move to a different service area). In September, before Open Enrollment Period Medicare beneficiaries get a document called Annual Notice of Changes which details the changes in their plan for the next calendar year. The drug coverage may change (for example the medication you take may no longer be covered or its costs may increase significantly) so it is very important to compare your plan to other plans available on the market. Please call us - we will be happy to help you with the drug analysis and will recommend the best plan!

If you have Medicare Advantage insurance, you most probably don't need a separate Prescription Drug Plan as Medicare Advantage plans usually cover medications. Again, those plans do change from year to year and you should really compare your plan with the coverage offered by other plans during the Annual Enrollment Period (October 15th to December 7th). 

Please call our agency for more information. We will conduct a thorough drug analysis and we will help you obtain the right plan for your needs.