Part D Drug Plans
The Part D prescription drug coverage is a must for all seniors.
Although you are not required to sign up for Part D there are penalties for not doing so. Those penalties are 1% of the national average of all drug plans. This may not sound like much, but you should consider that the penalty will be added on to the monthly premium of any plan you get in the future FOREVER. Also, you might not be able to sign up for Part D at the time you need it. In general, you can only sign up during the Annual Enrollment Period unless you qualify for an exception.
At Health Plan Advisors we will analyze your prescriptions to find the most cost effective plan for your situation. Any particular medication can be on one of several different "tier levels" with each company. Our analysis has saved our clients thousands of dollars.
Updated for 2025
Medicare Guidelines permit a yearly deductible of $590. Some plans with a deductible might have some covered medications that are not subject to that deductible.
If your plan has a deductible, once you've paid that amount you then go into the "initial coverage period" and will pay approximately 25% for your medications. Many plans may have a set dollar amount for some tier levels instead of a percentage.
When you've paid $2,000 out-of-pocket you go into the Catastrophic Coverage and will pay $0 for all covered medications. The "donut hole" is no longer a part of prescription drug plans.
New for 2025 is a payment plan which allows you to spread the cost of your medications over the remainder of the year. For example, if you get a medication that cost $600 in January you'll pay $0 at the pharmacy. You'll then receive a bill each month from the insurance company to pay off the medication. You must pay it off by December of that year.