Since Original Medicare (Part A and Part B) doesn’t cover all prescription drug costs, Original Medicare beneficiaries often have to take into consideration what they’re going to do about prescription drug coverage. Medicare Part D is one way to help cover the cost of prescription medications. Read on to learn more about Medicare Part D prescription coverage.
What is a Medicare Prescription Drug plan?
Medicare Prescription Drug plans—also known as Medicare Part D—help cover the cost of brand-name and generic prescription medications for Medicare beneficiaries. A Medicare Part D plan can be purchased as a standalone plan, to supplement Original Medicare, or to accompany a Medicare Supplement Insurance plan.
Another option for prescription drug coverage is a Medicare Advantage plan, also known as Medicare Part C. With a Medicare Advantage Prescription Drug plan, you’ll still receive the same coverage as Original Medicare, but may have access to additional routine benefits. You can purchase a stand-alone Prescription Drug plan (PDP) if your Medicare Advantage plan doesn’t include prescription drug coverage.
What was the Medicare coverage gap?
Previously, Medicare beneficiaries with significant drug expenses would enter the “coverage gap” or “donut hole”—the point where the total prescription drug costs reached a certain limit. As of January 1, 2025, the coverage gap has been eliminated. Once Part D beneficiaries reach $2,000 in out-of-pocket prescription drug costs, their plan will assume all costs for covered drugs until the end of the calendar year.
How to Get Prescription Drug Coverage
Medicare Part D is available to anyone eligible for Medicare coverage, but is only offered through private health insurance plans. Although you are not required to enroll in a Medicare Prescription Drug plan, there can be significant penalties if you choose to enroll in one later than your Initial Enrollment Period. To avoid any potential penalties and ensure prescription drug coverage when you need it, you should consider prescription drug coverage when you are first eligible for Original Medicare.
You can make changes to your prescription drug coverage during the Medicare Annual Enrollment Period (AEP), which runs from October 15 to December 7 each year, with the coverage going into effect January 1 of the following year. Part D plans can change their formulary and benefits each year, so it’s important to review your drug coverage during AEP. Even if your medications don’t change, it may be possible to save money on a different plan.
Explore Medicare Coverage with SelectQuote
If you’d like to learn more about Medicare Advantage coverage, SelectQuote can help you understand your options. In just minutes, our licensed insurance agents can compare Medicare Advantage options available in your area. It’s free and there’s no obligation to enroll.
2https://www.medicare.gov/drug-coverage-part-d/costs-for-medicare-drug-coverage/catastrophic-coverage
