Essential Reads Inside Our Book

Medicare Part D, helps cover the cost of prescription drugs; it is offered by private insurance companies and designed to work alongside Original Medicare. It is an optional program, which means the Medicare beneficiary does not have to enroll in a plan if they do not want prescription drug coverage. However, by not signing up for a Medicare Part D PDP when first eligible, a beneficiary will likely face a lifetime penalty if/when they decide to sign up later on.

Medicare Part D premiums are paid directly to the private insurance company. It has a deductible, copayments, and coinsurance for some drugs. The out-of-pocket costs to the beneficiary will depend on the Part D plan selected.

Medicare Part D does not cover all prescription drugs, and it does not cover drugs that are NOT medically necessary. It also does NOT cover drugs used for cosmetic purposes or for the treatment of weight loss or weight gain.

Plans change every year, so it is wise to seek out a local insurance agent to make sure the beneficiary is in a plan that is suitable for their needs.

Most Medicare drug plans have a coverage gap (also called the “donut hole”). This means there’s a temporary limit on what the drug plan will cover for drugs.