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Part D Prescription Drug Plans

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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 timbe 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 when to enroll.

 

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.

 

Making Part D work

 

Most Prescription Drug Plans have a coverage gap called a donut hole. This means there's a temporary limit on what the drug plan will cover for drugs. The coverage gap begins after you and your drug plan have spent a certain amount for covered drugs. For 2023, you're in the coverage gap once your plan retail drug cost reaches $4,660 in covered drugs. People with Medicare who get Extra Help paying Part D costs won’t enter the coverage gap.

Once you reach the coverage gap in 2023, you'll pay 25% of the retail cost for covered brand-name and generic prescription drugs. You will pay this pricing until the end of the year, or if you reach $11,206.28 during the year you will then go into the next level of coverage. Catastrophic coverage: which will reduce your co-payment of prescriptions to 5% of the retail pricing on brand and generic medications. This pricing would continue until the end of the year.

 

Choosing a plan

 

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

  • Start at MyMedicare.gov. You can find the basics about the benefit and Part D plans at Medicare's website. 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.

  • Learn more. We recommend consulting the website of the nonprofit Medicare Rights Center. There you can find in-depth information on Medicare Part D.

 

Getting financial help

 

Individuals with monthly income limits of $1,379 and financial resources of less than $8,400, or married couples with income limits  $1,851 and resources of less than $12,600, 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.

 

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