Evergreen Life & Health

Part D Prescription Drug Plans

Medicare Part D helps cover the cost of prescription drugs. It is offered by private companies and you choose either a stand-alone plan or drug coverage that comes inside a Medicare Advantage plan.

Two ways to get drug coverage

• Stand-alone drug plan (PDP): added to Original Medicare, often alongside a Medigap policy.
• Medicare Advantage with drug coverage (MA-PD): drug coverage is part of one plan that also covers Parts A and B.

Terms you will see

• Formulary: the list of drugs a plan covers, sorted into tiers. The tier decides what you pay.
• Deductible, copay and coinsurance: how your share of the cost is set.
• Annual out-of-pocket cap: Part D has a yearly limit on what you pay for covered drugs. For plan year 2027 the yearly cap is $2,400, the standard deductible is $700, and insulin is capped at $35 for a one-month supply.
• Late enrollment penalty: if you go without creditable drug coverage for a period after you first qualify, your monthly premium can be higher. We explain how it is calculated.
• Extra Help: a federal program that can lower drug costs for people with limited income and resources. We can point you to how to apply.

Before you choose, check

• That your current medications are on the formulary.
• The pharmacies you use, and whether they are in the plan's network.
• Any rules such as prior authorization or step therapy.

Questions people ask

• Is it required? Not everyone must enroll, but going without coverage can lead to a penalty later.
• Can I change? Yes, during certain enrollment periods. We explain the dates.

Not connected with or endorsed by the U.S. government or the federal Medicare program.