What Does Medicare Part D Cover?
Get a FREE QuoteMedicare Part D covers prescription drugs. You can get Part D coverage by adding on a standalone Part D plan to your Original Medicare coverage, or you can find a Medicare Advantage plan that includes prescription coverage as an extra benefit.
Keep in mind that if you choose the Medicare Advantage route, you have to be enrolled in Original Medicare before joining a Medicare Advantage plan!
Each Part D plan has a list of prescription drugs that it covers. This list is known as a formulary. All Part D plans are required to cover two drugs from each class. They are also required to cover all drugs in six specific categories, which are:
✔ Immunosuppressants
✔ Antipsychotics
✔ Antidepressants
✔ Anticancer
✔ Anticonvulsants
✔ HIV/AIDS drugs
Part D will NOT cover:
𝙓 Cosmetic drugs
𝙓 Fertility or erectile dysfunction medications
𝙓 Weight loss or weight gain drugs
𝙓 Over-the-counter drugs
Part D Tiers
Part D plans will also generally divide the prescription drugs they cover into tiers to lower costs. The tiers will vary depending on the plan, but an example of what they may look like can look something like this:
Tier 1 – Generic prescriptions with the lowest copayment
Tier 2 – Preferred, brand-name prescriptions with a medium copayment
Tier 3 – Non-preferred, brand-name prescriptions with a high copayment
Specialty Tier – High cost prescriptions with the highest copayment
Typically, a drug listed in a lower tier will be less expensive than a drug in a higher tier.
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Signature Medicare Solutions helps Medicare beneficiaries enroll in Medicare Advantage plans. Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply. Signature Medicare Solutions all rights reserved. Signature Medicare Solutions is not affiliated with or endorsed by any government entity. This is an advertisement for insurance. Not all carriers offer these benefits. Plans vary by region and state. Limitations and exclusions may apply. We do not offer every plan available in your area. Currently we represent multiple organizations which may offer several products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program to get information on all of your options. Plans are insured by a Medicare Advantage (HMO, PPO and PFFS) organization with a Medicare contract and/or a Medicare-approved Part D sponsor. Enrollment in a plan may be limited to certain times of the year unless you qualify for a Special Enrollment Period or you are in your Medicare Initial Enrollment Period. Enrollment depends on plan’s contract renewal with Medicare.