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.