Medicare Part D

When you’re on Medicare, Medicare Part D, the part of Medicare that covers prescription drugs. Also known as Medicare drug coverage, it’s not automatic—you have to sign up separately through a private insurance company approved by Medicare. If you don’t enroll when you’re first eligible, you could pay a late penalty forever, even if you don’t take meds now. Millions of people skip this step because they think they don’t need it, only to get hit with a $100+ monthly surprise later when they need a heart medication or insulin.

Not all Medicare Part D, the part of Medicare that covers prescription drugs. Also known as Medicare drug coverage, it’s not automatic—you have to sign up separately through a private insurance company approved by Medicare. plans are the same. Some cover cheap generics but charge high copays for brand-name drugs. Others have low monthly premiums but high deductibles—you might pay $500 out of pocket before coverage kicks in. Then there are plans with coverage gaps, called the donut hole, where you pay 100% of costs until you hit a certain spending limit. In 2024, once you hit $8,000 in total drug costs, you enter catastrophic coverage, where you pay just 5% of the cost. But if you’re on a plan with a high deductible, you might never get there.

Many people don’t realize they can save hundreds a year by using manufacturer savings programs, discounts offered by drug companies to lower out-of-pocket costs for brand-name medications. Also known as copay cards, these can cut your pill costs by 50% or more. But here’s the catch: some Medicare Part D plans don’t count those savings toward your deductible or out-of-pocket maximum. That’s called an accumulator program, and it’s legal. So you might think you’re saving money, but you’re still stuck paying full price until you hit your plan’s limit. Always check if your plan accepts copay cards before you sign up.

Another big mistake? Assuming your plan covers everything you take. Every Part D plan has its own formulary—a list of drugs it pays for. A plan that covers your blood pressure med might not cover your arthritis pain gel or your diabetes injection. And if your doctor switches your medication next year, your plan might drop it. That’s why you need to review your plan every fall during Open Enrollment. Even if you’re happy now, your drugs might not be.

People on low incomes can get extra help through the Low-Income Subsidy, which can cut monthly premiums to $0 and reduce copays to under $5. But many don’t apply because they think they make too much. The income limit is higher than you think—up to $21,000 for a single person in 2024. If you get Medicaid, SNAP, or SSI, you automatically qualify. If you’re unsure, call 1-800-MEDICARE. It’s free, and you won’t lose anything by asking.

Medicare Part D doesn’t cover everything. You won’t find coverage for over-the-counter drugs, weight loss pills, or most vitamins—even if your doctor recommends them. But it does cover most prescriptions used for chronic conditions like diabetes, heart disease, asthma, and depression. If you take five or more meds a day, you’re likely paying more than you need to. Some plans bundle drugs into tiers, and higher tiers mean higher costs. A generic statin might cost $10, but a brand-name version could cost $200. Always ask if there’s a generic alternative.

What you’ll find in the posts below are real, practical ways to navigate Medicare Part D without getting tricked. From how to compare plans side-by-side, to how to use patient assistance programs without getting burned, to what to do when your drug gets pulled from the formulary—you’ll see exactly what works for real people. No fluff. No sales pitches. Just what you need to know to get the most out of your coverage and keep your out-of-pocket costs as low as possible.