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Prescription Drug Plans

Prescription Drug Plans

Medicare Part D provides coverage for prescription drugs. The plan is exclusively offered through private companies, whether as a standalone plan for those with Original Medicare or as an additional benefit with a Medicare Advantage (Part C) plan.

Your job as an agent is to make sure your clients are aware of all their coverage options, especially when it comes to prescription drug coverage.

Here is what you need to know about Part D.

What Does Part D Cover?

Each Part D plan has a formulary (a list of covered drugs), but you need to double check with the provider that the Part D plan covers the prescriptions your client needs. All Part D plans must provide coverage for most, if not all of the drugs in these categories:

• All vaccines except the ones covered by Part B

• Anticancer

• HIV/AIDS

• Antipsychotic

• Antidepressants

• Anticonvulsive

• Immunosuppressants

Part D Enrollment

Part D is optional, but people often prefer to get it to cover their medication expenses. To enroll, an individual must be enrolled in Medicare Part A and/or Medicare Part B.

They can also enroll during their Initial Enrollment Period once they are enrolled in one or both parts of Original Medicare. This period is the first enrollment period to occur as it means the individual is now eligible to enroll in Medicare. It will start three months before their 65th birthday month and will end three months after their 65th birthday. Missing this period is not recommended.