Medicare Part D is an optional program that helps pay for prescription drugs. It does this through a variety of plans offered
by private companies that have been approved by Medicare. Part D is often called the “Medicare Prescription Drug Program.
Medicare Prescription Drug Coverage offers:
- Prescription drug coverage for everyone with Medicare regardless of income and resources, health status, or current prescription expenses;
- Both brand name and generic prescription drugs at participating pharmacies convenient to beneficiaries;
- Protection for people who have very high drug costs or from unexpected prescription drug bills in the future.
You may be able to get help with your costs to have Medicare prescription drug coverage if you have limited income and resources.
This program is called LIS/Extra Help. Unless you qualify for LIS/Extra Help, Medicare Part D is designed to share the costs of
prescription drug coverage with you, not pay all of your medicine costs.
Medicare drug plans are offered by insurance companies and other private companies approved by Medicare. People can choose
to join a Medicare drug plan that meets their needs based on coverage, cost, convenience, and customer service.
There are two types of Medicare Drug Plans:
- Medicare Prescription Drug Plan (PDP) – These plans add drug coverage to the Original Medicare Plan and some
other types of Medicare plans.
- Medicare Advantage Plan (MAPD) – This is an HMO or PPO and other Medicare health plan that includes prescription
drug coverage. You will get all of your Medicare coverage (Part A and B), including prescription drugs (Part D) through
Medicare drug plans cover generic and brand name drugs. To be covered by Medicare, a drug must be available only by
prescription, approved by the Food and Drug Administration, used and sold in the United States and used for a medically
accepted indication. Each plans will have a “formulary” that tells you which drugs are covered by the plan. Plans may
require prior authorizations, step therapy and quantity limits.