Navigating the world of Medicare can be confusing, especially when it comes to prescriptions. Understanding Medicare drug coverage can save you money, stress, and surprises at the pharmacy.
What is Medicare drug coverage?
Medicare drug coverage (Part D) helps cover the cost of prescription medications. Part D plans are offered by insurance companies, and you can get this coverage in two types of plans. There are stand-alone plans that add drug coverage to Original Medicare (Parts A and B) or a Medicare advantage plan (Part C) that includes drug coverage.
What does it cover?
Medicare Part D covers prescription drugs that are on your plan’s list of approved medications. It will often cover prescriptions for conditions like high blood pressure, diabetes, and high cholesterol. It also covers many vaccines, including the shingles vaccine and flu shots.
What is not covered?
Part D will not cover drugs not listed on your plan. It also does not cover over-the-counter medications such as Tylenol, vitamins, and cold medicine. Some weight loss or gain and fertility drugs are not covered. Cosmetic or lifestyle medications such as hair growth pills are not typically covered.
What does Medicare Part D cost?
The cost of Medicare Part D will vary based on the type of plan you choose. Depending on your plan, you could pay:
- Premium: This is the monthly amount you pay for coverage. It can range depending on your coverage type.
- Deductible: The amount you pay for covered drugs before your plan kicks in to cover the rest. Some plans have no deductible while others might. In 2025, no Medicare drug plan can be over $590.
- Copayments or coinsurance: This is a portion you pay each time you fill in a prescription at the pharmacy.
Is a Part D plan required?
Medicare drug coverage is technically optional. However, it is a great way to save money on expensive prescriptions and ensure you get access to essential medications. On top of this, if you do not sign up when you are first eligible and do not have other creditable prescription coverage, you will likely face a late enrollment penalty. This penalty is tacked onto your monthly premium and lasts as long as you have Part D coverage. So even if you are not taking medications now, enrolling early can save you money down the line.
Let’s talk
Your health deserves coverage that works as hard as you do. For a free quote, contact one of our experienced Avery Hall agents today at 410-742-5111 for Salisbury, 410-822-7300 for Easton, and 302-536-9470 for our Selbyville office.
Please note that we do not offer every Part D Prescription plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please visit Medicare.gov or 1-800-MEDICARE to get information on all of your options.