Medicare Part D offers prescription drug coverage to help beneficiaries afford the cost of medications. Part D plans are offered by private insurance companies approved by Medicare and vary in terms of coverage, costs, and formularies (the list of covered drugs). Part D coverage typically includes: • Retail Prescription Drugs: Coverage for prescription medications obtained from retail pharmacies, including brand-name and generic drugs. • Mail-Order Prescriptions: Many Part D plans offer the option to obtain prescriptions through mail-order pharmacies, often at lower costs and with the convenience of home delivery. • Preferred Pharmacy Networks: Some Part D plans may have preferred pharmacy networks, where beneficiaries can access lower copayments or coinsurance by using designated pharmacies within the network. • Coverage Gap (Donut Hole): Beneficiaries may enter the coverage gap, also known as the "donut hole," after reaching a certain threshold in drug costs. During this phase, they may be responsible for a higher percentage of their medication costs until they reach catastrophic coverage. Understanding the coverage provided by Part D plans helps beneficiaries select a plan that meets their prescription drug needs. 5.1 Understanding Part D Coverage Chapter 5: Medicare Part D - Prescription Drug Coverage 202404PMED1MDSIMPLE 13 www.Postal-Service-Health-Benefits-Program.com
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