Medicare Part D

Medicare Part D is a prescription drug coverage plan that can be purchased as a standalone plan with Original Medicare or included as an additional benefit with a Medicare Advantage Plan. Each Part D plan is required to cover certain drugs but always check with the plan to make sure your necessary prescriptions are also covered.

To be eligible for Part D, you must be enrolled in Original Medicare. 

What is covered?

Part D is required by Medicare to provide coverage for at least two drugs in each class. Part D must also cover all drugs in these specific classes:

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

What is not covered?

The drugs not covered by Part D include:

  • Over the counter drugs
  • Fertility drugs or drugs for erectile dysfunction
  • Hair growth drugs/cosmetic drugs
  • Weight loss/gain drugs

If any prescriptions are covered by your Part B plan, then Part D will also not cover those.

Part D Tiers

Part D plans place the drugs they cover into specific tiers. If a drug is in a higher tier, it will most likely cost more than a drug in a lower tier.

  • Tier 1: Preferred Generic – low cost preferred generic drugs
  • Tier 2: Generic – includes preferred generic drugs
  • Tier 3: Preferred Brand – includes preferred brand drugs
  • Tier 4: Non-Preferred Brand – includes non-preferred brand drugs
  • Tier 5: Specialty Tier – high cost brand and generic drugs

If you are in need of prescription drug coverage through Medicare but are unsure of how to obtain it, give CJC Advisors a call today! We will help you determine if you should purchase Part D as a standalone plan or obtain its coverage through a Medicare Advantage Plan.

CJC Advisors
can help!