Medicare Part D (PDP)

Medicare D, also known as PDP (Prescription Drug Plan) is designed to help offset the high prices of prescription drugs and premiums as well as protection from catastrophic costs should you encounter a situation where you need high-cost medication. It is offered by private insurance companies and can be added to your Original Medicare Plan (A and B + D) or it is oftentimes included if you have a Medicare Advantage Plan, as you cannot have both a PDP and Advantage at the same time.

The premiums for Medicare D are decided mostly by a list of prescription drugs covered by the plan called a formulary. It’s important to consider each plan’s formulary to make sure the drugs you need are available and covered under that plan.

*Monthly premiums vary by state, with adjusted premiums for those making more than $97,000 (or $194,000 for married couples filing jointly) known as Income-Related Monthly Adjusted Amounts (IRMAA).

High Prescripton Drug Costs

Medicare D offers a layer of protection against high prescription drug costs and is voluntary, but we recommend adding it when you enroll to avoid any late penalties should you decide to add it later on during Medicare’s Annual Enrollment Period (AEP) which runs from October 15th-December 7th each year. The AEP is also a great opportunity for beneficiaries to check any changes in the plan that may better suit your situation and needs.

Insurance carriers make yearly adjustments to the Medicare D plans based on pharmacies, premiums, formularies, and actuary tables- the AEP gives beneficiaries an opportunity to weigh those changes against changes in their own health needs to make sure you’re getting the best prescription coverage available.

There are several complex components involved in weighing the cost of deductibles and premiums, which we will dissect further in the coming blogs. For more information on how these percentages and figures factor into your coverage, call us today to see how we can save you money and make sure you’re paying less for the prescriptions you rely on most.

*Income based on 2023 standards