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:

The 2019 Drug deductible is up to $415.00 per year. 

Stage two

Initial Coverage Stage:

  • The Drug Benefit for 2019 is $3820.00 for the year.
  • Which means you just used 75% of your $3820 drug benefit on one Medication!
  • When you use your $3820 drug benefit, you will be in the gap or donut hole.

Stage three

Donut Hole:

In this stage for 2019, you will pay 25% of brand name drugs and 37% of the generic drug cost.

Stage four

Catastrophic Stage:

Example:  2019 – Once you reach this stage about 95% of your drug cost is covered by the plan, but it will cost you almost $5,100.00 to get to this stage.