Medicare Part D – Medicare’s Prescription Coverage

Medicare Part D is the part of Medicare that covers prescription drugs. medicare part dAlthough Part D is a “part” of Medicare, it is offered through private companies that are annually approved by the Centers for Medicare & Medicaid Services (CMS) to sell the plans.

The Medicare Part D plans vary considerably – both from one state to another and even within states. There are some minimum requirements that Medicare sets forth for the plans, but beyond that, companies can design their Part D plans (formularies, premiums, deductibles and co-pays) however they want. In 2015, Medicare Part D premiums range from $12/month to over $100/month, depending on the plan and area.

Because of this wide variance in plans, as well as the wide variance in medications that someone can be on, it really makes sense to compare the plans based on your current medication list. Medicare’s web site,, has a comparison tool, which allows you to enter your zip code, enter all of your medications by name/dosage, and enter your preferred pharmacy to come up with a relatively precise ranking (by overall annual cost) of the plans. This enables you to see which plan would give you the best “deal” over the course of an entire year, as well as determining what the co-pays are for each of your medications.

Some people choose to make a decision based on other factors, such as who they’ve heard of, what a plan is ranked or referrals/feedback from friends/family. Those are certainly all viable things to consider, but based on experience, strongly advocates for choosing a plan based on how well it covers your specific medications and overall cost to you. Keep in mind, also, that you can change Part D plans each year, during the annual election period, if you want/need to do so.

Lastly, as a point of clarification, does NOT sell Part D plans. We are an independent Medicare supplement broker. We are certainly happy to assist with your understanding of Medicare and comparison of Medicare Part D – we are specialized experts in Medicare and Medicare insurance, but we recommend signing up for Part D through Medicare itself (online or 1-800-MEDICARE) or through the company that you choose for your plan.

Other Considerations:medicare-part-d

  • Some of the plans have restrictions on certain medications – such as quantity limits, prior authorization and step therapy.
  • On some plans, co-pays may be lower at some pharmacies than others. If you have a specific pharmacy you prefer, it is always a good idea to take that into account in your comparison on
  • You can only change plans once a year during the annual election period (AEP), which runs October 15 to December 7 each year. The plans run with the calendar year, so any changes made during AEP take effect on 1/1. You should re-evaluate/re-compare your Part D plan at least every other year – plans change, medication lists change, co-pays change etc. It is not a “set it and forget it” type of insurance.
  • It is, in most cases, less expensive to get your medications using one of the mail order programs the plans offer.

If you have questions about Part D or want a Medicare supplement comparison, you can reach us online or at 877.506.3378.