Medicare Your Coverage Options

Medicare Part D drug plans: Three tips

Written by Diane Archer

Medicare offers prescription drug coverage through traditional Medicare or through a Medicare Advantage plan, and about 80 percent of people with Medicare–40 million–take advantage of it.  Here are three things to know about Medicare Part D drug plans and some information on costs.

Enrollment: If you have traditional Medicare and you don’t have drug coverage through your job, you might also want to have prescription drug coverage through a private insurer under Medicare Part D.  If so, you should sign up at the same time you sign up for traditional Medicare so that you have full coverage.  You might also need a Part D plan if you are enrolled in a Medicare Advantage plan.  If your income is low, you are eligible for help paying the cost of this coverage.  Call 1-800-Medicare (1-800-633-4227) to enroll.

Coverage: The Medicare drug benefit covers a part of your total drug costs. Each drug plan covers different drugs, under different conditions, and charges you different amounts for those drugs.  Because there is little standardization regarding what these plans cover, whether you need special authorization, and how much you pay and some terms can change at any time, it can be hard to figure out which plan to choose.  Click here for a Medicare tool that can help you choose a drug plan. Keep in mind that each fall you will need to study your options if you want to keep your costs down, since most drug plans change their premium, deductibles, copays and benefits from one year to the next.

Access: Each drug plan has its own rules on where you can fill your prescriptions. More and more have pharmacy networks and your costs will differ based on which pharmacy you use. Check to make sure the plan’s requirements meet your needs, both in your community and while you’re traveling.

For more information on how to save money on your prescription drugs, click here.

Here are some helpful facts from the Kaiser Family Foundation about the 2016 Medicare drug benefit:

  • The average drug plan monthly premium is $41.46. Some are as high as $60.
  • Two out of three plans have a deductible, an amount you must pay before the plan starts covering your drugs. The deductible can be as high as $360.
  • Many drug plans now charge coinsurance, a percentage of the cost, for brand-name and specialty drugs. They also tend to charge you different amounts depending on the pharmacy network you use.

For more information from the Medicare Rights Center, click here to visit Medicare Interactive.


  • The Centers for Medicare and Medicaid Services have set $34.10 as the “national base beneficiary premium” for Part D in 2016. That is the amount on which late payment penalties are calculated. Kaiser Family Foundation reports that $41.46 is the average premium, with some plans offering lower premiums and other higher premiums.

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