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Medicare Part D

Original Medicare consists of Part A hospital insurance and Part B medical insurance. Part C is Medicare Advantage, and Part D is prescription drug coverage. Prescription drug coverage can not be obtained through Original Medicare, so in order to receive this coverage, you must purchase a Part D plan. 

Prescription Drug Coverage

Part D prescription drug plans are administered by private insurance companies that have contracted with Medicare to provide Part D benefits. Only qualified insurers can sell these plans, so be sure to avoid sellers who are not licensed. Part D plans cannot be purchased if you have a Medicare Advantage plan, instead, you must seek prescription drug coverage through your provider or another insurer.

Part D Formulary

Each insurer tailors their policies based on what they wish to offer. Every Part D plan has a formulary that is a list of drugs that are covered. The different drugs are separated into different tiers based on cost and other factors. Every Part D plan must offer access to at least two drugs in each major category.

Drug Categories

If you have a Part D prescription drug plan, your insurer must cover all drugs from the following categories:

  • Anticonvulsive treatments for seizure disorders 
  • Antidepressants
  • Immunosuppressant drugs
  • Anticancer drugs (unless covered by Part B)
  • Antipsychotic medications
  • HIV/AIDS drugs

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How To Get Part D Coverage

To get prescription drug coverage through Original Medicare, you must contact an insurance provider who offers such plans. You can also enroll in a Medicare Advantage plan that has Part D coverage included. To find plans in Florida, seek help from a qualified insurance professional, such as the team at El-Mag Insurance. You can reach us at 954-674-1444.