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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).

Tiers

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)

Coverage

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:

  • Immunosuppressants
  • HIV/AIDS drugs
  • Antidepressants
  • Anticonvulsants
  • Antipsychotics
  • Anticancer

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.

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Need prescription drug coverage?

R&R Insurance Solutions can help you find a Part D plan that covers everything you need. Give us a call today and we’ll help you compare rates and coverage.