In the United States, Medicare is the federally-funded health insurance program for people over 65 years of age, as well as for some younger people with disabilities. There are different parts of Medicare, including Part A (hospital insurance), Part B (medical insurance), Part C (Medicare Advantage plans), and Part D (prescription drug coverage).
One of the most popular Medicare plans is Plan D. This plan covers prescription drugs, and it’s available to anyone who has Medicare Parts A and B. Some people choose to enroll in a Medicare Advantage plan instead of Part C, and these plans can also include prescription drug coverage. However, not all Medicare Advantage plans offer prescription drug coverage, so it’s important to check before enrolling.
There are also programs available to help people pay for their Medicare premiums and drugs. The Medicare Savings Programs can help people with low incomes pay for their Part B and/or Part D premiums and the Medicare Prescription Drug Assistance
People with Medicare can also purchase a separate prescription drug plan, called a Part D plan. These plans vary in terms of their coverage and costs, so it’s important to compare them before enrolling. Generally, Part D plans have a monthly premium, and they also require a deductible (the amount you have to pay before the insurance kicks in). In addition, there is usually a co-pay (the amount you pay for each prescription) and a limit on the number of drugs that will be covered.
It’s important to remember that Medicare does not cover all prescription drugs. There are also many medications that are not covered by Medicare at all. So it’s important to check with your doctor or pharmacist to see if your medication is covered by your plan.
Medicare Part D Coverage
Medicare Part D plan has a formulary — a list of medications it covers. Medicare requires the plan must offer at least two drugs in each class. Also, each plan cover all — or nearly all — prescription drugs in these classes:
- Anti-cancer medications
- HIV/AIDS drugs
Part D plans also cover common vaccines to prevent illness.
What drugs doesn’t Part D cover?
Prescription drug plans do not cover any medications Original Medicare covers for you. Other than that, there are a few medications that Part D will not typically cover including:
- Any weight loss or weight gain drugs
- Fertility medication
- Over-the-counter medication
- Erectile dysfunction medication
- Cosmetic drugs