Part D Prescription Drug Plans

You can sign up for Part D Prescription Drug Plans, which helps cover prescription drug costs, along with other components of Medicare starting three months before your 65th birthday.

It's important to do this on time because there's a permanent premium surcharge for enrolling more than three months after your 65th birthday if you don't have equivalent drug coverage from another source, such as a retiree plan.

Let us help you with your enrollment

If you are already enrolled in a Part D "standalone" plan or a Medicare Advantage plan that incorporates drug coverage, you can switch plans during the open-enrollment period, which runs from Oct. 15 to Dec. 7 every year.

How Part D works

Generally,  Medicare drug plans and Medicare Advantage Plans with drug coverage have 3 stages:

• Deductible stage: If your Medicare plan has a deductible, you pay all out-of-pocket costs until you reach the full deductible. No Medicare drug plan may have a deductible more than $615 in 2026. Some Medicare drug plans don’t have a deductible.
• Initial coverage stage: After you reach your full deductible (if your plan has a deductible), you’ll pay 25% of the cost as coinsurance for your generic and brand-name drugs until your out-of-pocket spending on covered Part D drugs reaches $2,100 in 2026 (including certain payments made on your behalf, like through the Extra Help program). Then, you’ll automatically get “catastrophic coverage.”
• Catastrophic coverage stage: You won’t have to pay out-of-pocket for covered Part D drugs for the rest of the calendar year.

When you have Medicare drug coverage, you’ll get an Explanation of Benefits (EOB) the month after the pharmacy bills your plan. Your EOB shows the prescriptions you filled, what your plan paid, what you and others have paid, your coverage stage, and what counts toward your out-of-pocket costs and your total drug costs.

Choosing a plan

It pays to review your Part D coverage every year, especially if you have started taking new drugs.

• Start at Medicare.gov, where you can find the basics about the benefit and Part D plans. There's a link to the Medicare Part D Plan Finder, which allows you to compare offerings and coverage options in your area and includes a helpful formulary finder that allows you to compare plans based on their coverage of your personalized list of drugs. It will even show you your monthly out-of-pocket drug cost for the year

Call us to help you understand your options.

Getting financial help

Individuals with annual incomes of less than $23,475 for a person or married couples with incomes of less than $31,725, might qualify for Extra Help from Medicare to pay their Part D premiums and out-of-pocket drug costs.

Download Medicare's instructions on applying for the Extra Help program.

Additionally, read about the six ways to lower your drug costs on Medicare.gov.

This information was obtained from www.medicare.gov

By contacting the phone number on this website you will be directed to a licensed agent.