Medicare
Prescription Drug Coverage (Part D)
Medicare Part D helps cover the cost of prescription medications through plans offered by private insurance companies.
What Is Medicare Part D?
Medicare Part D is the federal program that helps cover prescription drugs. Part D plans are offered by private insurance companies approved by Medicare. You can get Part D coverage either as a stand-alone prescription drug plan (PDP) or, in many cases, included within a Medicare Advantage plan that offers drug coverage.
Each plan has its own list of covered medications (formulary), pharmacy network, and cost-sharing structure. Because these can differ from plan to plan, understanding the details helps you anticipate what you may pay for your medications.
What to Consider When Reviewing Part D
Formulary
The list of medications a plan covers. Check whether your specific prescriptions are included and at what tier.
Pharmacy Network
Plans work with preferred pharmacies. Using in-network pharmacies can affect your cost.
Cost Sharing
Copayments, coinsurance, and deductibles vary by plan and by drug tier.
Medication Coverage
Some medications may have step therapy or prior authorization requirements.
Annual Plan Changes
Formularies and costs can change each year, so reviewing your plan annually is important.
Good to Know
Part D Changes From Year to Year
Drug coverage isn't set in stone. Plans can adjust their formularies, costs, and rules annually — which is why a yearly review of your coverage matters.
Medicare Disclaimer. Ocean Health Solutions is an independent insurance agency and is not affiliated with or endorsed by the U.S. government or the federal Medicare program. Medicare Advantage and Prescription Drug Plans are offered by private insurance companies that contract with Medicare. Product availability and eligibility vary by location.
Questions About Your Prescription Coverage?
A licensed insurance professional can help you review how your medications may be covered.