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What is a Prescription Drug Plan?

Original Medicare doesn’t cover prescription medications outside of the Hospital. Medication costs seem to be higher than ever and most people take some prescriptions drugs. The Medicare Prescription Drug plan (PDP) is an optional program that is offered through private insurance companies. Medicare regulates the format of Part D and sets in place guidelines that the insurance companies must follow. You are eligible for a PDP when you have Part A or Part A and B. You can be under age 65 with a qualifying disability or 65 when you are first eligible for Medicare, as well as over age 65 upon leaving creditable Prescription Drug coverage. You do not have to get a PDP, however if you chose not to, and you don’t have access to coverage for your medications by way of Group insurance, Indian Health Services, Veteran Affairs, or other means. You will be penalized for the time that you were eligible for coverage and chose not to take advantage of it. You can enroll in a PDP either in a stand-alone plan, or one that that is embedded in a Medicare Advantage plan. Each plan has a unique network of pharmacies, list of covered medicines, and its own set copays and deductible. It’s important that when you first are eligible for Medicare, and each year after that you compare your choices based on your specific list of medications that you are using at that time. 

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