What Does Medicare Part D Cover?

Medicare Part D provides prescription drug coverage through private insurance plans approved by Medicare. It helps cover the cost of both generic and brand-name medications.

What Drugs Are Covered?

Each plan has a formulary, which is a list of drugs it covers. Most formularies include medications for:

• Blood pressure
• Diabetes
• High cholesterol
• Mental health
• Pain management
• And more

Plans are required to cover drugs in all major therapeutic categories.

Coverage Tiers

Drugs are often divided into tiers:

• Tier 1: Low-cost generics
• Tier 2: Preferred brand-name drugs
• Tier 3+: Higher-cost or specialty medications

The tier affects your copay or coinsurance.

What’s Not Covered?

Part D usually does not cover:

• Over-the-counter medications
• Vitamins (with some exceptions)
• Drugs covered under Part B (like some injectable medications)

Choosing the Right Plan

When comparing Part D plans, consider:

• Your current medications
• Preferred pharmacies
• Monthly premiums and deductibles

Using Medicare’s Plan Finder Tool or talking to an advisor can help you make an informed choice.