Part D: Drug Coverage Options
Part D drug coverage is only available from private companies contracted with Medicare. You usually choose Part D drug coverage in one of two ways:
1. A separate “stand alone” drug plan and then you buy a separate Medicare Supplement Policy
2. Or you can get your part D drug coverage as part of a Medicare Advantage plan.
How the Part D drug plans work:
The term “Formulary” is a list of medications that the Part D drug plans or Medicare Advantage plans covers.
Note: ALL drug plans are not the same. You need an agent that will run your drug list based on the specific medications you are taking.
Give us a call. The Gary Smith Agency will be happy to run your drug list.
Drug Plan Stages
Stage One
Deductible Stage:
Most plans have an Annual deductible. But the deductible may not apply to all drug tiers. See the plan summary for details.
Stage Two
Initial Coverage Stage:
- In this stage you pay a co-pay or a percentage of the drugs total cost. The plan pays the rest.
- You will stay in this stage until you use all the benefits in this stage.
- Most people never leave Stage Two but once the benefit is used up, it is gone for that year.
- Once the Benefit is used up in Stage Two, you move to Stage Three.
Stage Three
Donut Holes:
In this Stage, you will pay 25% of the retail cost for your drugs. If your drug cost $100.00, your copay will be 25% or $25.00.
- Once the Benefit is used up in Stage Three, you move to Stage Four.
Stage Four
Catastrophic Stage:
This stage is the light at the end of the tunnel. You will pay a small copay or co-insurance amount. You will stay in this stage for the rest of the plan year.