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MEDICARE
PRESCRIPTION DRUGS

Prescription Drug Plans (Medicare Part D) are insurance plans specifically for prescription drug coverage for Medicare beneficiaries. They are a part of Medicare, but they are handled by Insurance companies directly. They are sold through those companies, or through brokers like me.

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ELIGIBILITY

Individuals on Medicare are eligible for prescription drug coverage under a Part D plan if they are signed up for benefits under Medicare Part A and/or Part B. Beneficiaries obtain the Part D drug benefit through two types of plans administered by private insurance companies or other types of sponsors: the beneficiaries can join a standalone Prescription Drug Plan (PDP) for drug coverage only or they can join a public Part C health plan that jointly covers all hospital and medical services covered by Medicare Part A and Part B at a minimum, and typically covers additional healthcare costs not covered by Medicare Parts A and B including prescription drugs (MA-PD).[3](NOTE: Medicare beneficiaries need to be signed up for both Parts A and B to select Part C whereas they need only A or B to select Part D.)

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EXCLUDED DRUGS

Part D coverage excludes drugs or classes of drugs that may be excluded from Medicaidcoverage. These may include:

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  • Drugs used for anorexiaweight loss, or weight gain

  • Drugs used to promote fertility

  • Drugs used for erectile dysfunction

  • Drugs used for cosmetic purposes (hair growth, etc.)

  • Drugs used for the symptomatic relief of cough and colds

  • Prescription vitamin and mineral products, except prenatal vitamins and fluoride preparations

  • Drugs where the manufacturer requires as a condition of sale any associated tests or monitoring services to be purchased exclusively from that manufacturer or its designee

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