Medicare Prescription Drug

There are 2 ways to get prescription drug coverage:

A standalone Medicare Prescription Drug plan (Part D). These plans (sometimes called “PDPs”) add drug coverage to original Medicare through a separate policy sold by a private insurance company. Or a Medicare Advantage plan (Part C) with prescription drug coverage.

What Medicare Part D drug plans cover

Each plan that offers prescription drug coverage through Medicare Part D must give at least a standard level of coverage set by Medicare. Plans can vary the list of prescription drugs they cover (called a formulary) and how they place drugs into different “tiers” on their formulary. It is important to look at your Part D formulary to determine what tier level your medications are. The tier level will determine how much you pay for the medication.

Monthly premium for drug plans

Most Medicare Prescription Drug plans charge a monthly fee that varies by plan. You pay this in addition to the Medicare Part B premium. If you join a Medicare Advantage plan (Part C) that includes Medicare prescription drug coverage, the plan’s monthly premium may include an amount for drug coverage

Costs for Medicare drug coverage

You’ll make these payments throughout the year in a Medicare drug plan:
Premium
Yearly deductible
Co-payments or coinsurance
Costs in the coverage gap
Costs if you get extra help
Costs if you pay a late enrollment penalty

Your actual drug plan costs will vary depending on:

The prescription medications you use
The plan you choose
Whether you go to a pharmacy in your plan’s network
Whether the medications you use are on your plan’s formulary 
Whether you get extra help paying your Medicare Part D costs