Medicare Basics: 5 Things to Know about Medicare Part D – Prescription Drug Coverage (Part of a Series)

There are four basic parts of Medicare: A, B, C, and D. Each part helps pay for certain medical services.  

Medicare Part D is health care coverage that helps you pay for the prescription drugs you use.

Here are 5 things to know about Part D – Prescription Drug Coverage:

1. Original Medicare (Parts A & B) does not cover most prescription drugs.  Beneficiaries must elect and buy this coverage in addition to Part A and/or Part B.
2. Everyone who qualifies for Medicare and enrolls in either Part A and/or Part B is eligible for Part D Prescription Drug Coverage.
3. Part D is only offered through private companies that contract with Medicare. You have two choices:
   • Stand Alone Prescription Drug Plans (PDPs)
   • Available through Medicare Advantage Plans (MAPDs)
4. Part D covers most outpatient drugs you get from the pharmacy or through mail order.  There are exceptions (eg. administered by a doctor, chemotherapy) that are covered under the other parts of Medicare.
5. There are four stages of Prescription Drug Coverage:
   • Annual Deductible
   • Initial Coverage
   • Coverage Gap
   • Catastrophic Coverage

With Part D Prescription Drug Plans (PDP), coverage and costs vary by plan and may change each year.

 You can read 5 things to know about Medicare Parts A and B in these previous posts:

Medicare Basics: 5 Things to Know About Medicare Part A

Medicare Basics: 5 Things to Know about Medicare Part B (Second in a Series)