Speak to a licensed agent and save up to $751 a year.

Prescription Drug Coverage

Prescription Drug Coverage
The letter D for drug is the quick way to remember what Part D is for. The prescription drug part of Medicare is used by 45 million Americans, and once you’ve enrolled in Original Medicare, you need to sign up for Part D to get access to the private insurance companies that offer prescription drug plans. As of 2023, 90% of Medicare Advantage plans offer prescription drug coverage, but if your Part C plan doesn’t, you can also buy a separate drug plan while under Part C.
If you’re covered by Medicare Parts A and B (Original Medicare) and have no plans to switch to a Medicare Advantage plan, it’s key that you enroll in a stand-alone plan so that you won’t be charged a late enrollment penalty. Note that if you have creditable coverage or are receiving Extra Help, this penalty won’t apply. Also, remember that many Medicare Advantage plans will include prescription drug coverage in your policy, but some do not.
Please enable JavaScript in your browser to complete this form.

How Do I Enroll?

Just like original Medicare, you need to sign up for Part D during the Initial Enrollment Period (IEP). This is the 7-month time beginning 3 months before your 65th birthday, including your birthday month, and ending 3 months after you turn 65.
After you’ve enrolled, you get a chance to review the prescription drug plans (PDPs) between October 15th and December 7th, or switch into a new plan if you’re not new to Part D.
Your drug coverage takes effect January 1.

To get the PDP you want, either:

When you join a Medicare drug plan, you’ll give your Medicare Number and the date your Part A and/or Part B coverage started. This information is on your Medicare card.
You can expect to wait about 5 weeks for your Part D membership card to arrive. If you need prescription medications during the wait period, most pharmacies will accept the acknowledgement letter from Medicare, or simply an enrollment confirmation number.


Premiums of the top 10 Part D plans with the largest enrollment averaged between $28/month to $76/month in 2023. Higher premiums apply to higher incomes, starting at $97,000 for a single person or $194,000 for a married couple. You also have a copay and coinsurance for your part of the costs.
The only other cost is your annual deductible. This is what you cover for your prescriptions before your Part D plan takes care of its share of your Medicare-approved prescription drugs. Deductibles range across a variety of plans, but for 2023 the maximum any plan can charge annually is $505.

Good-bye Donut Hole

Most Medicare plans have a gap in coverage that happens when you and your plan hit a certain amount for covered drugs before the end of the coverage period. This is the famous “donut hole,” and thanks to the Affordable Care Act, it closed in late 2019. 
In 2023, once your prescription drug costs reach $4,660, you fall into the coverage gap until you reach a $7,400 out-of-pocket limit — this is when so-called “catastrophic coverage” automatically kicks in. Be aware that these figures reflect the retail cost of the drugs, not what you paid toward them. In fact, your part of the $4,660 may be only $1,000 out-of-pocket. Your brand-name drugs will be covered at 75% in 2023. 
Medicare Supplement vs Medicare Advantage, Which One Is Right for You?

Is This the Right Plan for Me?

Aside from a cost that’s comfortable for you, there are a few other important details you want to nail down before making your choice:

The Plan’s Formulary

A formulary is simply the list of prescription drugs covered under the plan, and each Medicare Prescription Drug Plan has its own one. If you can’t find the medication or medications you need on a plan’s formulary, we suggest you talk with your physician about alternative medications.

The Plan’s Network

It’s fairly standard for a plan to come with an “in-network” list of approved pharmacies. These are selected on the basis of lowest prescription drug prices. The risk you take going out of network is that you may end up paying more for your medications.

The Mail Order Option

There are plans which offer you better prices for drugs you get via mail order pharmacies. Since your plan may require a three-month minimum per order, it may be smart to ask your doctor if the mail order option makes sense given the medications you need.

The Detail on Covered Drugs

Part D plans generally sort prescription drugs by tier, and each tier has a different cost. The rule of thumb is, the lower the tier, the lower the drug cost; and the higher the tier, the higher the drug cost.

It’s possible for your plan’s formulary to change during the year. Your plan is required to give you two options should your list of medications be affected by this change:

Here’s a breakdown of the different tiers and associated costs. Remember that you should inquire about how your plan structures its tiers since each plan has its own tier system.

Tier 1

Lower co-payment, offering most generic prescription drugs.

Tier 2

Medium co-payment, offering preferred brand-name prescription drugs.

Tier 3

Higher co-payment, offering non-preferred brand name prescription drugs.

Specialty Tier

Highest co-payment or co-insurance, offering specialized, high-cost prescription drugs.

Although Part D drug plans are entitled to provide their own formularies from the comprehensive list of covered prescription medications, they are barred from creating formularies which exclude specific drugs in order to discriminate against certain enrollees.

Should your plan not have a drug that you require, it’s in your rights to ask for a written explanation, and request an exception.

Formularies have to include at least two prescription drugs in each category, covering the bulk of medications in the six protected classes of prescription drugs:

Additionally, all available vaccines have to be covered by Part D when they are needed to prevent illness, except for vaccines covered under Medicare Part B.

For more detailed information regarding Medicare Part D visit medicare.gov.

Still confused? Call us!

We’re here at 833-245-0614 to answer any questions, and ready to help with any issues you might have with an insurer through the enrollment process.

Please enable JavaScript in your browser to complete this form.

Table of Contents


No, some MA plans do not include drug coverage although most do.

Yes. You need to enroll in Part D during your Initial Enrollment Period.

They vary from plan to plan, but the most you’ll pay in 2023 is $505.

The coverage gap will be closed by law by the end of 2019, but you should learn about how it works now.

  • Best overall Medicare supplement for new enrollees: Plan G
  • Best overall Medicare supplement before 2020: Plan F
  • Best low cost Medicare supplement: Plan K
  • Best alternative to Plan G Medicare supplement: Plan N

Learn More

Medicare Supplement policies are private health insurance designed to cover gaps in Original Medicare. They are also known as Medigap plans. These take care of costs such as copays, coinsurance, and deductibles which can become expensive if you need regular care from a doctor or hospital. If you need medical care while traveling outside the U.S., you can buy Medigap policies to help cover those costs. As a supplement to Original Medicare, you’re required to have Part A and Part B before you canget a Medigap policy. This way, Medicare is responsible for the Medicare-approved costs of the covered care, and the remainder is covered by your Medigap plan.

Learn More

Optimal coverage comes with higher costs, making Plan F the most expensive Medigap plan. Plan F is known as “first-dollar coverage” and it takes care of everything provided during a doctor or hospital visit. Your only responsibility is for dental, vision, medications, and equipment, such as hearing aids.

Learn More

The Federal government ended the Plan F option for new enrollees last year to keep the healthcare system from being overused by patients who had their deductibles covered. The next best coverage after Plan F is Plan G.

Learn More

Medigap Plan G offers every advantage of Plan F except for the deductible, which you have to cover. Because it isn’t as comprehensive as Plan F, Plan G is more affordable.

Learn More

For people who don’t go to the doctor often, Plan K is worth considering. It is the most affordable because it provides just 50% of Medicare Part B coinsurance, the Part A deductible, blood, skilled nursing, and Part A hospice costs. For comparison, Plan G and others offer full coverage of these expenses, and more.

Learn More

It’s hard to argue against plans which cut your traditional Medicare costs. For most people, having the extra coverage these supplemental plans provide is common sense, unless they want the specific features of a Medicare Advantage plan.

Learn More

Most people would benefit from not having to pay out-of-pocket to stay healthy. Medicare supplement insurance or a Medicare Advantage plan offer vital savings now, but are indispensable should a catastrophic health issue occur.

Learn More

Of the 10 Medicare-approved Medigap plans, Plan G and Plan N are the most popular. Plan F is no longer available to new Medicare enrollees as of 2020, but it is still popular among people who bought this plan prior to 2020.

Learn More

  • Plan F$128–$342
  • Plan F (high deductible)$22–$88
  • Plan G$106–$325
  • Plan G (high deductible)$29–$58

Learn More

Before getting a Medicare supplement plan, you need to be enrolled in Medicare Part A (hospital insurance) and Part B (medical insurance). People with Medicare Advantage Plans who want to go back to Original Medicare can buy a Medigap policy prior to switching.

Learn More

The security of having lower or no out-of-pocket healthcare costs can offset the premiums you’ll have to pay for whichever Medigap plan you choose, which vary depending on the benefits offered.

Learn More

The national average cost for Medicare Supplement Plan F is $1,824 annually, which is $152/month; Medigap Plan G will cost you around $143 per month.

Learn More

Since Plan F was discontinued for new enrollees as of 2020, Plan G offers the most coverage for people 65 and older. It has a lower premium than Plan F and duplicates its benefits, except for the Part B deductible.

Learn More

It depends on your specific needs, but for most people a Medigap plan is very useful in supplementing the coverage of Medicare Part A and Part B. A Medicare Advantage plan is an affordable way to get healthcare coverage not offered by Original Medicare.

Historically, Plan F has been the most popular because it covers all the out-of-pocket costs Medicare does’t pay for. This includes the 15% extra charge billed by providers who do not take Medicare as full payment.

Learn More

Since January 1, 2006, no Medigap policy came with prescription drug coverage. You have two options to get covered, enrolling in either a Medicare Prescription Drug Plan (Part D) or a Medicare Advantage plan.

Learn More

Have a Question? We've Got You Covered.

Please enable JavaScript in your browser to complete this form.