Understanding
Medicare Part D

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Medicare Part D covers prescription drugs.

Plans vary in coverage and costs, so it’s important to choose wisely. Key things to consider:
  • Monthly premiums
  • Covered medications
  • Deductibles and copayments

What Is Medicare Part D?

Medicare Part D is prescription drug coverage. It helps pay for the medications your doctor prescribes. These plans are offered by private insurance companies, not directly by Medicare, but they are approved and regulated by Medicare.

Why Is It Important?

Even if you don’t take many medications now, having a Part D plan protects you from high drug costs in the future and helps you avoid a late enrollment penalty.

What Does Part D Cover?

  • Brand-name and generic medications

  • Drugs for common health conditions (like high blood pressure, diabetes, cholesterol, etc.)

  • Each plan has a list of covered drugs called a formulary

  • You can usually search your medications to see if they’re covered.

     

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Fequently Asked Questions

What drugs does Medicare Part D cover?

Medicare Part D covers a wide range of prescription drugs, including both brand-name and generic medications. Every plan has a formulary (a list of covered drugs), which typically includes medications for common conditions like high blood pressure, diabetes, and cholesterol.
Plans are required to cover drugs in most major categories, but it’s important to check that your specific medications are on the plan’s list before enrolling.

Not anytime—there are certain periods when you can make changes:

  • Annual Enrollment Period (Oct 15 – Dec 7): You can switch plans for the following year.

  • Initial Enrollment Period: When you first become eligible for Medicare.

  • Special Enrollment Periods: If you move, lose coverage, or qualify for programs like Extra Help.

Outside of those periods, you generally have to stay with your plan until the next enrollment window.

Yes, but it’s best to make sure your pharmacy is in your plan’s preferred network.
Using a preferred pharmacy can lower your copays and out-of-pocket costs. Many plans also offer mail-order options that ship prescriptions directly to your home—sometimes with added savings.

Yes—if you don’t enroll when you’re first eligible and don’t have other creditable drug coverage, you could face a late enrollment penalty later on. Getting a low-cost plan now can protect you from paying more down the road.

Costs vary by plan and where you live. Most plans have:

  • A monthly premium

  • An annual deductible

  • Copayments or coinsurance for your prescriptions
    Some people may qualify for Extra Help, which reduces these costs.

Medicare Part D covers a wide range of prescription drugs, including both brand-name and generic medications. Every plan has a formulary (a list of covered drugs), which typically includes medications for common conditions like high blood pressure, diabetes, and cholesterol.
Plans are required to cover drugs in most major categories, but it’s important to check that your specific medications are on the plan’s list before enrolling.

Each Part D plan has a list of covered drugs called a formulary. It’s important to check this list to make sure your medications are included before enrolling in a plan.

If your current coverage is creditable (equal to or better than Part D), you may not need a Part D plan. But always check to avoid penalties or coverage gaps if things change.

You can enroll:

  • When you first get Medicare (your Initial Enrollment Period)

  • During the Annual Enrollment Period (Oct 15 – Dec 7) each year

  • If you qualify for a Special Enrollment Period, like moving or losing other drug coverage

You can’t usually switch plans outside of enrollment periods unless you qualify for a special situation. That’s why it’s important to choose a plan that covers a wide range of medications and to review your plan every year during open enrollment.