Learn how Medicare Part D Prescription Drug coverage works and what it covers
What is Medicare Part D
Prescription drugs can be expensive, and Original Medicare usually doesn’t provide coverage. A Medicare Part D plan is a stand-alone prescription drug plan that helps pay for prescription drugs that are not covered by Original Medicare.
Medicare Part D: Prescription drug plans
| How it works | What it helps cover | What you pay |
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You can add stand-alone Part D coverage to Original Medicare or a Medicare Supplement or Medicare Cost plan that doesn’t have prescription drug benefits. |
Part D plans help pay prescription drug costs. The types of drugs covered and the pharmacies you can use vary by plan. |
If you add a stand-alone Part D plan, you will pay a monthly premium. You may also pay a prescription drug deductible and a copay or coinsurance for your prescriptions. |
What you should know
Medicare Part D Extra Help program
The Extra Help program helps with the cost of your prescription drugs, like deductibles and copays. You can apply for Extra Help any time before or after you enroll in Part D.
Coverage gap phase elimination
The coverage gap phase will be eliminated in 2025. Out of pocket costs (OOP) will be capped at $2,000 and members pay $0 for drugs during the catastrophic coverage stage (after total OOP costs reach $2,000).*
Avoid a Part D penalty
If you don’t sign up for a Medicare Part D plan when you’re first eligible and you don’t have other coverage that’s as good as or better than a standard Part D plan, you’ll pay a late enrollment penalty if you sign up later.
The penalty is added to your monthly premium and you must pay it if you have Part D coverage.
So even if you don’t take prescription drugs now, consider enrolling when you’re first eligible.
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