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Part D, or prescription coverage

The fourth part of Medicare, Part D, is your prescription drug coverage. Without Part D, any medications you may need could cost hundreds or even thousands of dollars. 

Coverage is available as a standalone prescription drug plan (PDP), or as a Medicare Advantage plan with prescription drug coverage (MAPD), but it must be purchased through a government sponsored private insurance company that contracts with Medicare, like Geisinger Gold

To join a PDP or MAPD plan, you need to have Medicare Parts A and B and live in the service area of the plan.

How does Medicare Part D coverage work?

All Part D plans work the same way and are made up of 3 coverage periods.

1- Initial Coverage Period

  • Once you meet your annual deductible, you enter the first period, called the Initial Coverage Period.
  • During this coverage period, your prescription benefits begin until you reach a limit that is set by Medicare.
  • Once this limit is reached, you enter the second coverage period.

2- Coverage Gap

  • This second period is also commonly referred to as the “donut hole.”
  • While in the Coverage Gap, you will pay a much higher share of your drug costs. But like the first period, there is a coverage limit for this period as well.
  • Once you hit the Coverage Gap limit, you will enter the third period.

3- Catastrophic Coverage

  • The third and final coverage period is called Catastrophic Coverage.
  • During this final period, you will pay a small percentage of your prescription costs until the end of the year.

How much does Medicare Part D cost?

While all Part D plans work in the same way, they have important differences such as premiums, copays and which medications are covered. It’s important to find a plan that covers the medications you currently take.

If I don’t take any medications, do I need to sign up for part D?

Yes, it’s important to enroll in Part D when you are first eligible even if you have few or no prescription drug costs. Similar to Part B, if you do not sign up in your initial eligibility period, the premium will increase for each month until you do enroll. 

Once you’re enrolled, your premium won’t increase with your age and you cannot be denied because of a pre-existing health condition, the number of medications you take or your income. 

Geisinger Gold Medicare Advantage HMO, PPO, and HMO SNP plans are offered by Geisinger Health Plan/Geisinger Indemnity Insurance Company, health plans with a Medicare contract. Continued enrollment in Geisinger Gold depends on annual contract renewal.