ONE — Nelly Diaz Agency, Insurance Advisors

What it covers

How Part D coverage works

Part D coverage is offered through private companies approved by Medicare. Plans follow Medicare rules, but covered drugs, pharmacies and other details vary from plan to plan.

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  • Prescription drugs

    Helps pay for prescription drugs. Plans generally cover both brand-name and generic drugs, depending on the plan's drug list.

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  • Drug list (formulary)

    Each plan has its own list of covered drugs, called a formulary. It helps to check whether your medications are on it.

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  • Pharmacy networks

    Plans generally work with a network of pharmacies. Using a pharmacy outside the network may affect what the plan covers.

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  • Two ways to get it

    You can add a separate drug plan to Original Medicare, or join a Medicare Advantage plan that includes drug coverage.

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  • Late enrollment penalty

    A late enrollment penalty may apply if you go without Part D or other creditable drug coverage for a period after you are first eligible.

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  • Changes from year to year

    Plans and their drug lists can change from year to year, so reviewing your coverage each year can help.

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Why it matters

Know how your medications are covered

Part D plans do not all cover the same drugs or work with the same pharmacies. Looking at your current medications and the pharmacies you use can help you understand how a plan would work for you.

Drug coverage from an employer, union or other source may count as creditable coverage. That plan generally tells you whether its coverage is creditable, which can matter if you enroll in Part D later.

The right drug coverage depends on your situation, including the medications you take and where you get them.

Answers

Medicare Part D questions

Straight answers to common questions. If yours is not here, call or text our agency.

Not necessarily. Each plan has its own drug list, so whether a specific medication is covered depends on the plan.

It is drug coverage expected to pay, on average, at least as much as Medicare's standard drug coverage. Having it can matter when it comes to the late enrollment penalty.

Many Medicare Advantage plans already include drug coverage. If your plan does, you generally get your drug coverage through that plan. We can help you review how your plan works.

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Tell us what you need

Your name, a number that reaches you, an email, and a few quick questions about the coverage you pick. Our team reviews it and calls you back.

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A few questions about Medicare
Where are you with Medicare?
Do you have Part A and Part B?
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Next step

Let’s review your needs to find the coverage that fits you.

Request a quote online, or call or text our agency. If your current policy already fits, we will tell you that too.