"Medicare Annual Election Period (AEP) is Oct 15 – Dec 7. Schedule your mandatory annual prescription and plan review today!"
Medicare Parts A and B do not cover the retail prescription medications you pick up at the pharmacy counter. Part D is the private insurance program designed to keep your medication costs affordable.
🔍 How to Secure Part D Coverage
Because the government does not sell drug plans directly, you must choose one of two paths to get Part D:
A standalone Prescription Drug Plan (PDP) to pair with Original Medicare and a Supplement.
A Medicare Advantage Plan (MAPD) that has drug coverage built right into the policy.
📊 The 4 Phases of Part D Costs
Every Part D plan utilizes a unique "Formulary" (a tiered list of covered medications) that cycles through four distinct spending phases throughout the year:
The Annual Deductible: You pay 100% of your retail drug costs until you hit the plan's deductible limit (many plans waive this for Tier 1 generic drugs).
The Initial Coverage Phase: You pay a small copay or coinsurance, and the insurance plan pays the rest.
The Coverage Gap (The "Donut Hole"): Once your total drug spending hits a specific threshold, you enter the gap, where you are responsible for 25% of the cost of brand-name and generic drugs.
The Catastrophic Phase (The $2,100 Safety Net): Thanks to structural healthcare updates, once your out-of-pocket prescription drug spending hits the annual cap, you owe $0 out of pocket for the rest of the calendar year.
⚠️ The Creditable Coverage Deadline
Even if you do not take any prescription medications today, you should still enroll in a baseline Part D plan when you turn 65. If you go 63 consecutive days or more without "creditable" drug coverage, Medicare will levy a permanent late enrollment penalty that accrues monthly for as long as you maintain coverage.
👉 Let’s run your current prescription list through the formulary engine to find your lowest-cost option.