What does it Cover?
All Part D plans have a list of covered prescription drugs known as the formulary. The formulary contains all the medications covered by the plan under different groups. It is important to carefully examine a plan to ensure it contains the medications you need before purchasing it.
Part D plans are required by Medicare to cover HIV medications, antipsychotics, anticonvulsants, cancer treatment drugs, antidepressants, and immunosuppressants. Some common vaccines that are used to prevent illnesses are also covered by Part D.
Part D does not cover dietary supplements, weight control drugs, hair loss treatments, and over-the-counter medications.
Part D Tier System
All Part D plan formularies have a tier system. The tier system contains the type of drugs covered and are grouped by cost. Part D plans may have different tier systems and may contain different medications. Tier 1 typically contains preferred generic medications, which are the cheapest, while the highest tier contains specialty prescription medications.
All Part D plans cover a mixture of generic and brand name medications.
Several factors affect the cost of Part D plans. There are plans with $0 deductibles, while some plans may have a high deductible of up to $505.
Part D enrollees must pay premiums, copays, and coinsurance costs for their plan. While Part D premiums can be as low as $1.60 and as high as $113, the average Part D premium for 2023 is $31.50. Typically, the higher your income, the more you may have to pay. Other factors that affect the cost include location and the type of prescription drugs.
For those who cannot afford their Part D costs due to low-income, a program known as the Part D Extra Help Program can assist you.
You can either purchase a standalone Part D plan or a Medicare Advantage Plan that offers prescription drug coverage. You can enroll for Part D during the Initial Enrollment Period, Annual Enrollment Period, or during a Special Enrollment Period.
Part D plans can help you save money on prescription drug costs. To get help with choosing a Part D plan in Oregon that covers what you need, contact us today.
CMS Required Disclosure
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area.
Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.