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Part D Prescription Drug Plans

Part D Prescription Drug Coverage - Unlike Parts A & B, Part D is administered by private insurance companies offering plans providing coverage for your prescription drugs. This coverage helps lower your prescription drug costs and help protect you against higher costs during the year. Like other insurance, if a beneficiary decides not to enroll in a drug plan when they are first eligible, they'll pay a penalty if they choose to join later. Beneficiaries enroll in a drug plan and pay a monthly premium. In January 1, 2006, Medicare prescription drug coverage became available to everyone with Medicare.


You can sign up for Part D Prescription Drug Plans, which helps cover prescription drug costs, along with other components of Medicare starting three months before your 65th birthday. It's important to do this on time because there's a "lifetime penalty" for enrolling more than three months after your 65th birthday, or having a gap in coverage longer than 63 days, if you don't have creditable drug coverage from another source, such as an employer or retiree healthcare plan.

Let us help you with your enrollment

If you are already enrolled in a Part D "standalone" plan or a Medicare Advantage plan that incorporates drug coverage, you can switch plans during the Open Enrollment Period, which runs from Oct. 15 to Dec. 7 every year.

Making Part D work

In 2023, you will be facing higher out-of-pocket drug costs before you can qualify for catastrophic coverage. The out-of-pocket spending threshold will increase by $350, from $7,050 to $7,400.

You will also face higher out-of-pocket costs in 2023 for the deductible and in the initial coverage phase before reaching the catastrophic coverage. The standard deductible is increasing from $480 in 2022 to $505 in 2023, while the initial coverage limit is increasing from $4,430 in 2022 to $4660 in 2023.

For costs in the coverage gap phase, beneficiaries will pay 25% for both brand-name and generic drugs, with plans paying the remaining 75% of generic drug costs. For total drug costs above the catastrophic threshold, Medicare pays 80%, plans pay 15%, and enrollees pay either 5% of total drug costs or $3.95/$9.85 (2023, $4.15/$10.35) for each generic and brand-name drug, respectively.



Choosing a plan

It pays to review your Part D coverage every year, especially if you have started taking new drugs.

  • Our agency uses the Medicare Plan Finder allowing us to compare coverage offerings and options in your area and includes a helpful formulary finder that allows you to compare plans based on their coverage of your personalized list of drugs. It will even show you your monthly out-of-pocket drug cost for the year. We will be happy to set-up your account.

Call us to help you understand your options.

Getting financial help

Your combined savings, investments, and real estate are not worth more than $30,950, if you are married and living with your spouse, or $15,510 if you are not currently married or not living with your spouse you might qualify for Extra Help from Medicare to pay their Part D premiums and out-of-pocket drug costs.

Download Medicare's instructions on applying for the Extra Help program.

Additionally, read about the six ways to lower your drug costs on

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