Prescription drug (Part D)
Standalone Part D drug plans with formularies, tiers, and spend phases.
What it covers
- What it pays for
- Helps pay outpatient prescription drugs via private plan formularies.
- How it works
- Formulary tiers with a deductible, then copays or coinsurance until the annual out-of-pocket cap.
- Who can get it, and when
- No health underwriting; late enrollment without creditable coverage triggers a permanent premium penalty.
What it costs
A premium that varies by plan, a deductible, then copays until you reach the yearly out-of-pocket cap. After the cap, covered drugs cost you nothing.
Hawkins Insurance Group, LLC is not connected with or endorsed by the United States government or the federal Medicare program. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
What is good about it
- Insulin costs are capped each month
- Wide range of plan options and formularies
The catch
- Formulary restrictions (prior auth, step therapy)
- Premiums, deductibles, and formularies change annually
Mistakes to avoid
- Not understanding the new benefit structure. The IRA removed the coverage gap ("donut hole") and added a yearly out-of-pocket cap
Common questions
- Each Part D plan lists covered drugs organized into tiers that determine your copay. Check your specific medications against the formulary each year.
Keep learning
Other coverage to explore