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Prescription coverage · Part D

Making sense of Part D prescription drug coverage.

Part D plans differ in which medications they cover and what you pay at the pharmacy. Here is what to look at — and how drug coverage fits with the rest of your Medicare.

Three prescription bottles with blank labels on a stone countertop in soft daylight

What to look at

The formulary — your drug list
Every plan keeps a list of covered medications, sorted into cost tiers. The same prescription can sit on a different tier — or be missing — from one plan to the next.
Your pharmacy matters
Plans have preferred pharmacies where your costs are lower. It is important to recognize whether your pharmacy is a good fit.
More than the premium
The cheapest premium is not always the cheapest plan. Deductibles, copays, and coverage rules all shape what a year really costs you.
Enroll on time
Going without drug coverage after you're eligible can add a lifelong late-enrollment penalty. Even people who take no medications usually benefit from a basic plan.

Is it right for you?

If you have Original Medicare — with or without a Medigap policy — a standalone Part D plan is usually how your prescriptions get covered. If you have creditable drug coverage from the VA, TRICARE For Life, or an employer plan, you may not need Part D at all.

That's worth checking rather than guessing: the answer depends on your coverage, your medications, and your pharmacy. Plans also change their drug lists every year.

Common questions

I have VA drug coverage. Do I need Part D?

Often no — VA drug coverage is creditable, meaning you can skip Part D without a penalty. Some veterans still add a plan for pharmacy flexibility closer to home. It depends on how you fill prescriptions.

When can I enroll or switch plans?

Around your 65th birthday, during the Annual Enrollment Period each fall (October 15 – December 7), or during a Special Enrollment Period after certain life events.

What happens if I enroll late?

Medicare adds a permanent late-enrollment penalty to your premium if you go too long without creditable drug coverage.

Questions about your
whole Medicare picture?

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