Medicare Part D Prescription Drug Plans


Medicare Part D Prescription Drug Plan Basics

Part D is optional benefit for prescription coverage for people with Medicare A and/or B that is offered through private insurance companies that contract with Medicare

✔ It can be purchased as a stand-alone plan to accompany Medicare (with our without a Medicare supplement plan), or

✔ It may be included in a Medicare Advantage Plan

✔ If a Medicare beneficiary does not enroll in Part D when first eligible, there may be a late enrollment penalty upon future enrollment

Part D plans may charge a monthly premium and may include 4 stages of coverage: deductible, initial coverage level, coverage gap, catastrophic level

✔ Some Part D plans are contained in Medicare Advantage plans that do not charge a premium

✔ Some stand-alone plans do not charge a deductible

✔ All Part D plans provide the same benefit amount during the initial coverage period

✔ Premiums, deductibles, initial coverage amount, and out of pocket costs can change yearly

Each Part D plan has a formulary (list of drugs) that it covers

✔ Drugs, which are put into tiers, may require a prior authorization, have quantity limits or require Step Therapy (trying a less expensive alterative first)

✔ Formularies can change on a yearly basis

The Value of Working With Stoner & Company

  • We will analyze the drug plan options available to you using your list of medications and preferred pharmacy to determine the best option for your initial enrollment in a Part D plan
  • That analysis will include an explanation of your monthly costs during each stage of the Part D benefit
  • As your needs change or your Part D plan makes changes, we are available on a yearly basis during the Annual Enrollment Period (October 15-December 7) to review your options and make recommendations for the following year
  • In certain cases, we will also refer you to additional resources like pharmacy assistance programs, or to other discount programs/outlets to fill your prescription for greater savings or when a drug is not covered by Part D