What are the enrollment requirements
YOU MUST BE ENROLLED IN MEDICARE A & B
You Must live in the plan’s service area
Whether you choose a stand-alone plan or an Advantage plan, you must enroll during a designated enrollment period.
What Medicare Part D drug plans cover
Each plan must give at least a standard level of coverage set by Medicare. Plans can vary the list of prescription drugs they cover (called a formulary) and how they place drugs into different “tiers” on their formularies.
Plans include both brand-name prescription drugs and generic drug coverage. The formulary includes at least 2 drugs in the most commonly prescribed categories and classes.
Here’s an example of a Medicare drug plan’s tiers (your plan’s tiers may be different):
- Tier 1 – most generic prescription drugs
- Tier 2 – preferred, brand-name prescription drugs
- Tier 3 – non-preferred, brand-name prescription drugs
- Specialty tier – high cost prescription drugs
How does Part D coverage work?
For plans with a deductible, this is the amount you may have to pay before your drug plan begins to pay its share of your covered drugs.
You pay only the plan's copay or coinsurance for your covered drugs. You stay in this stage until your year-to-date drug costs total $4,430.
You pay 25% of the price for all drugs (plus a portion of the dispensing fee). You stay in this stage until your year-to-date out-of-pocket costs total $7,050.
Your share of the cost for a covered drug will be either 5% coinsurance or $3.95 for a generic drug and $9.85 for all other drugs, whichever is greater. Your plan will pay the rest of the cost.
You have many options
Don’t get confused about all the different terms and numbers you see here. It’s our job to help you find the plan that will work for you.
You have no obligation to do anything if you decide to give us a chance. All our services are free to you, we get paid by the insurance companies if you decided to apply for a plan throughout us.
You will NOT be talking to someone in a call center, we are local agents in your community.