Medicare Part D
Part D provides prescription drug coverage. It can be included in a Part C plan as an added benefit, or it can be purchased as a standalone plan with Original Medicare.
Eligibility for Part D includes being enrolled in Medicare Part A (hospital insurance) and/or Medicare Part B (medical insurance).
Part D divides certain drugs into tiers, with the highest tier usually consisting of the highest costing drug. A drug in a lower tier will typically cost less than a drug in a higher tier.
- Tier 1: Preferred Generic
- Tier 2: Generic
- Tier 3: Preferred Brand
- Tier 4: Non-Preferred Brand
- Tier 5: Specialty Tier (includes higher costing brand name and generic drugs)
Part D must cover two drugs from each class, but each Part D plan can decide which specific drugs of those classes it will cover.
Each Part D plan is also required to cover all drugs in these specific categories:
- HIV/AIDS drugs
Part D plans do not cover over the counter drugs, hair growth or cosmetic drugs, fertility drugs, drugs for erectile dysfunction, or weight loss or weight gain drugs.