Prescription Drug Plans

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• Medicare drug plans. These plans add drug coverage to Original Medicare, some Medicare Cost Plans, some Private Fee‑for‑Service plans, and Medical Savings Account plans. You must have  Medicare Part A (Hospital Insurance) and/or  Medicare Part B (Medical Insurance) to join a separate Medicare drug plan.
• Medicare Advantage Plan (Part C) or other  Medicare Health Plan with drug coverage. You get all of your Part A, Part B, and drug coverage, through these plans. Remember, you must have Part A and Part B to join a Medicare Advantage Plan, and not all of these plans offer drug coverage.

Before you make a decision, learn how prescription drug coverage works with your other drug coverage. For example, you may have drug coverage from an employer or union, TRICARE, the Department of Veterans Affairs (VA), the Indian Health Service, or a Medicare Supplement Insurance (Medigap) policy. Compare your current coverage to Medicare drug coverage. The drug coverage you already have may change because of Medicare drug coverage, so consider all your coverage options.

If you join a Medicare Advantage Plan, you’ll usually get drug coverage through that plan. In certain types of plans that can’t offer drug coverage (like Medical Savings Account plans) or choose not to offer drug coverage (like certain Private Fee-for-Service plans), you can join a separate Medicare drug plan. If you’re in a Health Maintenance Organization, HMO Point-of-Service plan, or Preferred Provider Organization, and you join a separate drug plan, you’ll be disenrolled from your Medicare Advantage Plan and returned to Original Medicare.

You can only join a separate Medicare drug plan without losing your current health coverage when you’re in a:

• Private Fee-for-Service Plan
• Medical Savings Account Plan
• Cost Plan
• Certain employer-sponsored Medicare health plans

Talk to your current plan if you have questions about what will happen to your current health coverage.

• Tier 1—lowest copayment: most generic prescription drugs
• Tier 2—medium copayment: preferred, brand-name prescription drugs
• Tier 3—higher copayment: non-preferred, brand-name prescription drugs
• Specialty tier—highest copayment: very high cost prescription drugs

 The cost of a one-month supply of each Part D-covered insulin is capped at $35 and you don't have to pay a deductible. If you get a 60- or 90-day supply of insulin, your costs can’t be more than $35 for each month’s supply of each covered insulin.