Original Medicare (Parts A and B) does not cover prescription drugs (those you buy at a pharmacy). Therefore every Medicare beneficiary should have a Prescription Drug Plan (Part D). Those plans are offered on a stand alone basis or as part of Medicare Advantage plans. 

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If you have Original Medicare (preferably with a Medicare Supplement) then you need to purchase a stand alone Prescription Drug Plan.

If you have a Medicare Advantage plan it probably covers your prescriptions. In this case you don't need a separate PDP plan.

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All Part D plans have to meet certain requirements, however they can differ considerably in regards to their formularies (the drug lists) and the coverage.  They also vary in monthly premiums (the lowest premium plan in the Chicago area is $0, the highest is $125.80 per month (for year 2025). 

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Before you choose a Prescription Drug Plan you should find out how much you will pay for your medications with a particular plan. We conduct such drug analysis for our clients (free of charge)- so that you will know the costs of your medications for the entire calendar year.

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You should also buy a Prescription Drug Plan when you are first eligible (when you first enroll in Medicare Part A or Part B). If you don't have a Prescription Drug Plan or other creditable coverage while you were Medicare eligible, you may owe a late enrollment penalty later.

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You cannot enroll in a PDP plan at any time! Apart from your Initial Enrolment Period (when you're first eligible for Medicare) you can get a PDP plan when you lose your employer coverage (you have 2 months after the end date of your employer plan), and in a few other specific cases. Please call our agency for more details.

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Prescription Drug Plans can be changed during the Annual Enrollment Period (from October 15th to December 7th) and under special circumstances (for example when you move to a different service area). In September, before Annual Enrollment Period Medicare beneficiaries receive an Annual Notice of Changes which specifies the changes in their plan for the next calendar year. The coverage may change (for example the medication you take may no longer be covered or its costs may increase) and the premiums change too. Also your situation and needs may have changed- for example you may have new medications. So, during the Annual Enrollment Period it is essential to compare your plan with other plans available on the market.

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Please call us - we will be happy to do a drug analysis and will recommend the best plan!

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Similarly, if you have a Medicare Advantage plan, during Annual Enrollment Period you should check how your plan covers your medications compared to other plans available on the market.

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Please call our agency for more information. We will conduct a thorough drug analysis and we will help you obtain the right plan for your needs.   

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