Medicare Part D is a voluntary outpatient prescription drug benefit for people on Medicare. During the Medicare Part D open enrollment period, which runs from October 15 to December 7 each year, beneficiaries can choose to enroll in prescription drug plans (PDPs). Beneficiaries with low incomes and modest assets are eligible for assistance with Part D plan premiums and cost sharing.

To the left, you will see an example of how Medicare Part D plans will help cover the cost of your medications. Medicare Part D has 4 stages of coverage.

  1. Deductible- The amount you pay first before the plan kicks in

  2. Initial Coverage Period- The plan pays 75% of the drug cost. You are responsible for the other 25%

  3. Coverage Gap (Donut Hole)- You will pay a higher percentage in this stage. Brand name: 40% Generic: 51%.

  4. Catastrophic Coverage- Once the cost of medication reaches this limit the plan will pay 15%. Medicare will pay 80%. You will pay an estimated 5%.

Here is a short breakdown of what Medicare Part D Plans will cover. Below you will see the definition of a formulary and how medications are divided into tiers.

Medicare Part D

Medicare Part D

Medicare Part D
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Medicare D Explained

Medicare D Explained

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Medicare D Cost Sharing

Medicare D Cost Sharing

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