What is Medicare Prescription Drug Coverage?

Also called Medicare Part D, Medicare Prescription Drug Plans are stand-alone plans that add prescription drug coverage to your Medicare Parts A and B coverage. Part D plans are offered by Medicare-approved private companies and the cost of each plan depends on the provider and your location.

What is a drug formulary?

The Medicare Part D plans are not standardized, which means, each company can cover or not cover special drugs based on a formulary. A formulary is simply a list of covered drugs.

The plan can change the formulary anytime, but they must notify you.

Each plan has a different list of drugs. You’ll want to find the formulary that fits with the medications you take.

Our certified brokers can compare the plans to determine the companies best suited for your unique list of drugs.

Lower your drug costs

Medicare drug plans have contracts with network pharmacies. These pharmacies have agreed to provide members of certain Medicare plans with services and supplies at a discounted price. In some Medicare plans, your prescriptions are only covered if you get them filled at network pharmacies.

Along with retail pharmacies, your plan’s network might include preferred pharmacies, a mail-order program, or an option for retail pharmacies to supply a 2- or 3-month supply.

  • Preferred pharmacies. If your plan has preferred pharmacies, you may save money on your out-of-pocket prescription drug costs (like a copayment or coinsurance ) at a preferred pharmacy because it has agreed with your plan to charge less.
  • Mail-order programs. Some plans may offer a mail-order program that allows you to get up to a 3-month supply of your covered prescription drugs sent directly to your home. This may be a cost-effective and convenient way to fill prescriptions you take regularly.
  • 2- or 3-month retail pharmacy programs. Some retail pharmacies may also offer a 2- or 3-month supply of covered prescription drugs.
There are 2 ways to get Medicare drug coverage:
  1. Medicare drug plans. If you purchase a Medicare Supplement Plan, you’ll need to also purchase a stand alone drug plan in order to cover your RX cost. Medicare Supplement plans do not offer drug coverage.
  2. Medicare Advantage Plan (Part C) or other Medicare health plan with drug coverage. You get all of your Part A, Part B, and drug coverage, through these plans. Remember, you must have Part A and Part B to join a Medicare Advantage Plan, and not all of these plans offer drug coverage

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PRP Insurance offers plans from a wide range of insurers, allowing us to shop and compare plan benefits.

Speak with a licensed agent and get expert advice on choosing a plan that’s right for you.

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