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Medicare Part D is a prescription drug plan offered by federally approved private insurers.

You can get Part D coverage  by either purchasing a stand-alone plan to go with Original Medicare coverage or by enrolling in a Medicare Advantage plan with prescription drug benefits.

Part D plans are sold by private insurers and are available to anyone enrolled in Original Medicare. There is no required physical exam, and you cannot be denied for financial or health reasons.

Though Medicare Part D is optional, you may have to pay a late enrollment penalty if you don’t apply once you are eligible.

What does medicare Part D cover?

Medicare Part D helps seniors afford necessary medications, which is why Part D is also known as PDPs, or Prescription Drug Plans.

The 2024 standard limits are as follows:

  • Initial Deductible: $545
  • Initial Coverage Limit: $5,030
  • Out-of-Pocket Threshold: $8,000

What does Part D cost?

The cost of a Part D plan varies depending on the insurance company. Each plan has a monthly premium, annual deductible, and a share of prescription costs, called a copay.

By having a combination of Medicare Parts A, B, and D, you can have a comprehensive health care plan.

What is the Coverage Gap?

Also known as the donut hole, is the period of reaching your initial coverage limit when you’re responsible for a larger percentage of prescription costs.

The coverage limit includes brand-name drug discounts and your yearly deductible, coinsurance, and copayments.

The coverage gap is only temporary (hence the donut hole), since the plan begins helping to pay for coverage drugs again once you reach the out-of-pocket threshold of your plan. The limit is different for each plan, so it is important to keep that in mind when choosing a Part D plan for yourself.

Where can I see the available plans?

The Medicare Plan Finder shows all of the available prescription drug plans available in a given zip code, along with their monthly premiums and annual deductible. You are able to input your own prescription drugs into the medicare.gov website in order to evaluate which plan works best for your medication needs. If all this information is overwhelming, you can always contact one of our licensed agents as we’re here to find the best plan to fit your needs.

Published: Aug 21, 2023 Medicare Costs Medicare Coverage

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