Wondering if it’s sensible to enroll in a Medicare prescription drug plan? It may be a good idea if you routinely take pricey prescription drugs. You may also want to get covered if your current prescription drugs are slated to rise in the future and may not be able to afford the copayments. Here’s what you need to know so you don’t miss out.
Best Providers for Medicare Prescription Drug Plans:
- Best Overall for Prescription Drug Plans: easyMedicare
- Cheapest for Prescription Drug Plan: Aetna
- Best for Customer Service: WellCare
- Best for Coverage Network: Humana
- Best for Drug Inclusion: UnitedHealthcare
- Best Providers for Medicare Prescription Drug Plans:
- Medicare Prescription Drug Plans: An Overview
- Medicare Prescription Drugs Plans Eligibility
- Medicare Prescription Drug Plans Cost
- An Overview on Medicare Open Enrollment
- Best Medicare Prescription Drug Plans and Providers
- Choose a Medicare Prescription Drug Plan with Ease
- Frequently Asked Questions
Medicare Prescription Drug Plans: An Overview
Worried about prescription drug costs? A Medicare prescription drug plan may offer much-needed relief at an affordable price. But what are Medicare prescription drug plans and how do they work?
For starters, it’s helpful to know that they comprise 1 of 4 types of plans:
- Medicare Part A: Hospital insurance
- Medicare Part B: Medical insurance
- Medicare Part C: Medicare Advantage that merges Part A and Part B
- Medicare Part D: Prescription drugs
Medicare prescription drug plans supplement Original Medicare plans because most don’t offer prescription drug coverage. They offer 4 tiers of coverage to make drug costs more affordable:
- Tier 1: Generic prescription drugs
- Tier 2: Preferred, brand-name prescription drugs
- Tier 3: Non-preferred, brand-name prescription drugs
- Specialty tier: High-cost prescription drugs
Higher tiers mean you’ll make more expensive copayments. But you may qualify for a lower copayment for medications in a higher tier if you file an exception with your provider.
Professionally-administered drugs may be covered under Original Medicare or Medicare Part A and B but these plans can help you save even more money on prescriptions.
Quick note: If you’re currently enrolled in a Medicare Advantage plan that offers prescription drug coverage, the provider will terminate your policy if you join a Part D plan. Most Medicare Advantage policies include coverage for prescription drugs, so it wouldn’t make sense to carry both.
If you don’t have adequate prescription drug coverage or are paying out of pocket, a Medicare Part D plan is definitely worth considering. Medicare Supplemental Insurance (or Medigap) won’t help offset prescription drug costs — it only works with Part A and Part B plans.
You can get a quote for coverage right away by entering your age and ZIP code. It only takes a minute of your time, and there’s no obligation to enroll.
Medicare Prescription Drugs Plans Eligibility
To be eligible for a Medicare Prescription drug plan, you must meet the following criteria:
- 65 years of age or older
- Have Original Medicare
oungerwith a qualifying disability
end-stagerenal disease that mandates dialysis or a kidney transplant
The enrollment windows for Medicare prescription drug plans are as follows:
- Initial enrollment period: Spans a total of 7 months (3 months before your 65th birthday, your birthday month and 3 months following your 65th birthday)
- Annual enrollment period: October 15 to December 7
- Special enrollment period: You can enroll at any time for select circumstances.
Medicare Prescription Drug Plans Cost
Drug costs under most Medicare Part D plans are low, the amount you pay will vary by the provider. There are 5 types of expenses to know:
- Premiums: The amount paid each month to keep your plan active.
- Annual deductible: The amount you must pay before coverage kicks in. By law, this amount is capped at $435 annually and some plans require 0 deductibles.
- Copayments: The set amount you pay each time you fill a prescription.
- Coinsurance: The percentage of the drug cost you’re responsible for.
- Coverage gap costs: Applies once your plan covers $4,020 in drugs — it also means you’ll be responsible for higher out-of-pocket costs.
Here’s a chart that includes drug costs for Medicare Prescription Drug Plans offered by the top providers in the U.S.
|Plan Name||Company||Plan Type||Drug Costs|
|Cigna-HealthSpring Rx Secure-Essential||Cigna||Drug plan (Part D)||Preferred generic: $19 (copay) |
Generic: $20 (copay)
Preferred brand: 20%
|SilverScript Choice (PDP) S5601-022||Aetna||Drug plan (Part D)||Preferred generic: $0 (copay) |
Generic: $1 (copay)
Preferred brand: $47 (copay)
|Wellness Rx (PDP)||WellCare||Drug plan (Part D)||Preferred generic: $8 (copay) |
Generic: $15 (copay)
Preferred brand: $47 (copay)
|Premier Rx Plan (PDP)||Humana||Drug plan (Part D)||Preferred generic: $5 (copay) |
Generic: $10 (copay)
Preferred brand: $47 (copay)
|AARP Walgreens Rx Plan||UnitedHealthcare||Drug plan (Part D)||Preferred generic: $15 (copay)|
Generic: $20 (copay)
Preferred brand: $47 (copay)
An Overview on Medicare Open Enrollment
Open Enrollment is the yearly period when you can enroll in a health insurance plan.
Open Enrollment runs from November 1 through December 15, 2020. Coverage starts January 1, 2021. If you don’t enroll in a plan by December 15, you can only get 2021 Marketplace coverage if you qualify for a Special Enrollment Period.
Get a quick overview of the Health Insurance Marketplace and find out whether you’ll save on health insurance coverage, including information on the following changes:
- 29 prescription drug plans
- More than 100 Medicare Advantage (MA) plans, including a new Medicare Medical Savings Account MA option
- Part D senior savings model for diabetic supplies
- Acupuncture, telehealth
andother virtual services
Best Medicare Prescription Drug Plans and Providers
We’ve compiled a list of the best Medicare Prescription Drug Plans and providers to facilitate your search. Our top picks offer comprehensive coverage at affordable rates and deliver exceptional customer service.
Refer to the formulary (or list of covered drugs) to confirm the medications you need are covered. Medicare requires that policies cover at least 2 drugs in the most common classes and categories. So if your specific drug is not listed, there’s probably a similar option.
Don’t forget to review anticipated costs and copayments to ensure the plan works for your budget.
1. Best Overall: easyMedicare
The aptly named easyMedicare makes Medicare — you guessed it — simple. easyMedicare’s licensed sales agents provide personalized one-on-one help to guide you through your available plan options and discuss your healthcare insurance needs. Its licensed sales agents can guide you to choose the best plan for you.
Just enter your ZIP code and you can compare plans easily in your area. easyMedicare.com lets you shop many of Medicare’s respected health insurance carriers: Humana, UnitedHealthcare, Cigna-HealthSpring, Aetna, Wellcare and others.
2. Most Affordable Prescription Drug Plan: Aetna
Aetna’s worth considering if you’re on a fixed income. Its affordable SilverScript Part D plans have low premiums and copayments that make it easier to get the drugs you need without stretching your budget too thin.
You’ll spend between $21 and $58 in premiums for SilverScript Choice (PDP) plans and $57 to $101 in premiums for SilverScript Plus (PDP) plans on average.
Plans feature an array of generic and brand-name drugs with no deductible. You’ll also enjoy $0 copayments on Tier 1 drugs when you fill your prescriptions at preferred retail pharmacies.
3. Best for Customer Service: WellCare
WellCare specializes in Medicare Advantage and Medicare prescription drug plans. WellCare can help you select the best plan for your prescription drug needs.
It currently serves over 15 million customers in 32 states and it’s committed to offering top-notch service so you can stay healthy.
4. Best for Coverage Network: Humana
Looking for a provider that offers an extensive coverage network? Consider an affordable Medicare Prescription drug plan from Humana.
Humana offers 3 Part D plans to choose from:
- Humana Basic R Plan (PDP) provides copayments between $0 and $1 on covered generic drugs once you’ve met your deductible.
- Humana Premier Rx Plan (PDP) features no deductibles or copays on 90-day supplies of Tier 1 and Tier 2 drugs.
- Humana Walmart Value Rx Plan (PDP) offers a premium of only $13.20 per month and enables you to save a bundle on covered generics at Walmart and Sam’s Club pharmacies.
Humana also extends coverage for deliveries so you can get the medications you need without leaving your home. You may be eligible to participate in the Medication Therapy Management (MTM) program if you take multiple medications prescribed by several providers.
5. Best for Drug Inclusion: UnitedHealthcare
The AARP MedicareRx Walgreens plan covers an array of generic and brand-name drugs. You won’t have copayments on prescription drugs and no deductible on both Tier 1 and 2 drugs. You may also be eligible for $15 cost savings or more on select prescriptions. An AARP membership isn’t required to qualify for coverage.
This plan is most ideal if you live near a Walgreens because you’ll have to fill your prescriptions there. Use Walgreens’ online store finder to find a location near you.
Choose a Medicare Prescription Drug Plan with Ease
When you’re ready to get started, we’ve got you covered. You can get a quote from the top Medicare Prescription Drug plan providers in just 60 seconds to make your search simple. Just enter your ZIP code and age. Before you select a suitable option, collect quotes from at least 5 providers to ensure you’re getting the best deal.
If you would rather get on the phone to secure a prescription drug plan, dial 1-866-760-0776 to get started.
Frequently Asked Questions
Are you wondering what people are asking for about Medicare? See if you have some of the same questions.
1) Q: What are the different parts of Medicare?
Medicare has 4 parts named Parts A, B, C, and D. Part A provides hospitalization coverage while Part B provides outpatient coverage, like doctor visits. Parts A and B make up Medicare’s core coverages. Part C is provides private-market Medicare plans, called Medicare Advantage Plans. Part C coverage often includes additional benefits. Medicare Part D provides coverage for prescription drugs. Get a Medicare Insurance Quote through the top providers here.
2) Q: Is Medicare free?
Because there are 4 parts to Medicare, there can be different cost structures. Most people won’t have to pay for Medicare Part A (hospitalization). Eligibility for premium-free Part A is based on your work history during which you paid Medicare taxes. Many people do pay a monthly premium for Medicare Part B, however, which covers outpatient medical services, like doctor visits. Deductibles also apply to services covered under Medicare Parts A and B, so you’ll pay a part of the annual cost.
Medicare Parts C and D are optional coverages and have premium costs of their own. Medicare Part C refers to Medicare Advantage Plans that offer additional coverage in exchange for a monthly premium. Part D, the prescription plan, reduces the cost of medications but also requires a monthly premium. Subsidies may be available for low income households to help reduce overall Medicare costs.
3) Q: Do I need to sign up for Medicare?
If you signed up for Social Security before age 65, you were enrolled in Medicare automatically but benefits will begin at age 65. In most cases, there are penalties for not enrolling at age 65, so it pays to sign up on time. Click here to get a medicare quote in minutes from the best providers.
If you have employer coverage, you may be able to delay Medicare coverage while your work plan is still in force. However, the size of the employer determines whether you’ll pay a penalty for not enrolling at age 65. Employees (and their spouses) of companies that offer group health insurance to 20 or more people are usually exempt from late sign-up penalties if they are covered by the employer’s plan.