What Is Medicare Part D?

Medicare Part D is prescription drug coverage available to Medicare beneficiaries through private insurance plans. Unlike Original Medicare, Part D is not a single, universal plan—you have multiple options and must choose a plan from an approved private insurer. Each plan has its own list of covered medications (formulary), costs, and participating pharmacies, so selecting the right one depends on your specific prescriptions and needs.

How does Medicare Part D work?

• Standalone plans: You can add Part D to Original Medicare (Parts A & B).
• Included in Medicare Advantage: Some Medicare Advantage (Part C) plans already include Part D coverage.
• Coverage tiers: Plans use a formulary that categorizes drugs into different cost tiers—lower-tier drugs cost less than higher-tier ones.
• Out-of-pocket phases: Costs change throughout the year, including the deductible stage, initial coverage, coverage gap ("donut hole"), and catastrophic coverage.

Why consider Medicare Part D?

• Reduces prescription costs: Helps cover expensive medications.
• Protects against high drug expenses: Once in catastrophic coverage, beneficiaries pay little or nothing for covered drugs.
• Offers nationwide coverage: Part D plans are available in every state, though costs and formularies vary.

How Solace can help

A Solace advocate can help you compare Part D plans, check if your medications are covered, and explain cost-saving programs like Extra Help. If you face high drug costs or coverage denials, Your advocate can assist with appeals and research alternative medication options.

What to do next

Choosing the right Part D plan can be complicated. A Solace advocate can guide you through your options and help maximize your benefits. Find an advocate today.