Medicare
Medicare Part D without the jargon
Part D is drug coverage. It can stand alone with Original Medicare, or it can be folded into a Medicare Advantage plan.
Original Medicare’s Part A and Part B do not work like a modern drug card. Outpatient prescriptions are handled by Part D. You can buy a standalone Part D plan if you stay with Original Medicare. If you join a Medicare Advantage plan that includes drugs, that plan’s drug list replaces a separate Part D plan. You do not stack a second Part D on top of a Medicare Advantage plan that already covers drugs.
Formularies and tiers
Each plan has a formulary, the list of drugs it covers, sorted into tiers. A generic on a low tier might be a small copay. A brand drug on a high tier can cost much more until you move through the plan’s payment stages. Plans can change formularies from year to year. A plan that covered a medicine in January may move it in the next contract year. Check the specific drug, dose, and pharmacy, not just the plan’s star rating.
Late enrollment has a cost
If you go without creditable drug coverage after you are first eligible, Medicare can add a late-enrollment penalty to the Part D premium later. Employer or union drug coverage is often creditable. The plan should tell you if it is. Keep that letter. The penalty is easy to ignore in the year you feel healthy and hard to undo later.
This is not a plan finder. Use Medicare.gov’s plan compare, or a State Health Insurance Assistance Program, with your actual medicine list.