Loading...Loading...What is Medicare Part D?
Medicare Part D covers a wide range of prescription drug costs that aren’t covered by Original Medicare (Part A and Part B). It also provides coverage for some vaccines, like shingles.
You can enroll in Part D once you’re eligible for Medicare Part A or enrolled in Part B. You can pair a stand-alone Part D plan with Original Medicare or choose a Medicare Advantage plan that includes Part D coverage.
Coverage gap: After the initial coverage limit is met, you enter the coverage gap, also known as the donut hole. You’ll pay 25% of your plan’s negotiated price for generic and brand-name drugs until your spending on prescription drugs reaches the total out-of-pocket threshold.
In 2025, as part of the Inflation Reduction Act, the coverage gap (donut hole) phase will no longer apply. Instead, there will be a lower $2,000 out-of-pocket maximum. As a result, Medicare Part D prescription drug coverage will have three phases: deductible, initial coverage and catastrophic.
If you don’t choose a Medicare Part D plan when you’re eligible, and don’t have other creditable drug coverage, there will be a permanent penalty added to your Part D premium for every month you could have enrolled but didn’t. So it may pay to enroll even if you don’t use prescription drugs now.
Taking multiple medications can increase the risk of drug interactions, side effects and other complications. Through the Medication Therapy Management (MTM) program, you can get one-on-one guidance from a pharmacist or other trained health care provider. They’ll make sure your medications are safe and working for you—and may help you find lower-cost options.
Last updated 10/22/2024
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