Medicare Part D Prescription Drug Plan

  • Medicare Part D plans covers a wide range of prescription drugs.
  • Medicare Part D plans including most drugs in certain protected classes,” like drugs to treat cancer or HIV/AIDs.
  • Medicare Part D plans come with a list of covered drugs (formulary) specific to the plan.
  • Medicare Advantage and Medicare Part D plans place drugs into different levels called “tiers” on their formulary. Drugs in each tier have a different cost. For example, a drug in a lower tier will generally cost you less than a drug in a higher tier.

 

Note
Starting January 1, 2021, if you take insulin, you may be able to get Medicare drug coverage that offers savings on your insulin. You could pay no more than $35 for a 30-day supply. 

 

  • Tier 1—lowest  copayment : most generic prescription drugs
  • Tier 2—medium copayment: preferred, brand-name prescription drugs
  • Tier 3—high copayment: brand-name prescription drugs
  • Tier 4—higher copayment: non-preferred, brand-name prescription drugs
  • Tier 5—highest copayment: Specialty tier highest cost prescription drugs

 

Medicare Part D Formulary Exception