What does Part D cover?

Clever RX - Prescription Savings

Medicare covers more than just hospital and outpatient costs. While Part A and Part B can be a significant help when dealing with these costs, they do not account for the medications you will need. This is where Part D comes in. Part D covers prescription medication costs, as well as vaccinations.

Does Part D come automatically when I sign up for Medicare Parts A and B?

No, Medicare Part D requires a separate enrollment. Medicare Part D is offered through private companies that are compliant with Medicare’s rules.

However, Medicare Advantage Plans is the exception to this, since it comes as a bundle including Parts A, B, and D. Being enrolled in a Medicare Advantage Plan may allow for more coverage for your medications.

What types of drugs are covered?

Medicare Part D is comprised of different prescription drug plans. Different plans have different formularies (list of covered medications). Six medication categories are covered. These six are:

Antidepressants
Anticonvulsants
Immunosuppressants
HIV/AIDS medications
Anti-Cancer
Antipsychotics

Plan D prescription drug plans must cover at least two prescription drugs in each of the six categories.

Drug plans are not required to cover drug categories such as:

Medications taken for cosmetic reasons (e.g., hair growth and weight loss medications)
Anti-anxiety or insomnia medications
Prescription cough medicines
Erectile dysfunction or fertility medications
Compound drugs (this is where you are taking medication at a higher dose than what is covered) must be compounded to reach the needed dose. In this instance, you will be paying the full price for the medication.

Are there medications covered by other Medicare Plans?

Medicare Part D is not the only option that offers medication coverage. While not as extensive as Part D, Part B can provide help in these situations:

Medications administered during medical treatment at a doctor’s office, such as ones given during chemotherapy
Vaccines
End-Stage Renal Failure medications
Supplies used in diabetic treatment (e.g., glucose monitors)

Have questions?

We are here to assist you with any inquiries you may have regarding Medicare and the various aspects of it. We won’t let any question go unanswered. We will address all concerns you have because at Sannes Insurance, we are dedicated to your needs.

Call us today at (509) 993-9887 for more information.

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