About Medicare Part D Prescription Plans

Even if you don't use prescription drugs now, most people need them to stay healthy as they age. So we encourage everyone who is eligible for Medicare to think about whether a Part D plan is right for them.

You'll find answers to commonly asked questions about Part D below. For additional information about Medicare Part D prescription drug coverage and other Medicare-related issues, visit the official Medicare Web site.

What is a Part D plan?

All Part D plans are private insurance plans offered by private companies. There are two kinds of Part D plans. Stand-alone plans, or PDPs, cover prescription drugs only. MA-PD (Medicare Advantage plus Prescription Drug) plans include medical coverage for doctor visits and hospital expenses. They also cover prescription drugs. Evercare offers several MA-PD plans. To see which Evercare health plans are available where you live, go to Find Plans & Services.

How much will it cost?

Most participants pay monthly health plan premiums and a yearly deductible. Your premium helps provide predictable coverage that helps protect you from unexpected changes in your prescription drug costs today and in the future. If you have limited income and resources, you may qualify for extra help. You can apply or get more information by calling Social Security at 1-800-772-1213 (TTY 1-800-325-0778) between 7:00 AM and 7:00 PM Monday through Friday or visiting their Web site.

What drugs are covered?

Each Part D drug plan has its own Prescription Drug List (PDL), a government-approved list of medications covered by the plan. PDLs vary from plan to plan, but all plans offer you and your doctor a number of choices. Before you commit to a plan, it's a good idea to look at the plan's PDL to make sure that it meets your needs.

Will my Part D plan pay for my medications?

You'll probably pay a portion of the cost for each prescription and the plan will pay the rest. We negotiate lower prices with drug companies and pass those savings along to you.

In some cases, you may be responsible for 100 percent of the payment. If you use the pharmacies in the plan's network, you'll benefit from our negotiated prices. (See "coverage hole" in the glossary.)

When do I have to sign up?

You can join a Medicare drug plan from three months before you turn 65 to three months after the month you turn 65 (called your Initial Enrollment Period). Generally, if you are disabled, you can join three months before and three months after your 25th month of disability. The plan will notify you when your coverage begins.

Please keep in mind that if you choose to enroll in a Medicare prescription drug plan after the close of the enrollment period, you will be subject to a late enrollment penalty fee (unless you qualify for an exception). If you have a Medicare plan without prescription drug coverage, you will not need to change your Medicare plan coverage, but you will need to decide whether or not you wish to enroll in a Medicare prescription drug plan. A penalty fee may apply if you decide to enroll in a Medicare prescription drug plan after the close of the open enrollment period.