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Medicare Prescription Drug Plans

Medicare Prescription Drug Plans are an optional benefit available to all Medicare beneficiaries. There are only two ways to get coverage for Medicare Prescription drugs. A beneficiary must either enroll into a Medicare Health Plan (usually a Medicare Advantage Plan) that includes prescription drug coverage, or they must enroll into a stand-alone prescription drug plan. Both of these options for Prescription drug coverage are offered by private companies.

Who can Enroll in a PDP?

Any Medicare eligible beneficiary can enroll into a Prescription Drug Plan. In order to be eligible, a beneficiary must either be entitled to Part A or enrolled in Part B of original Medicare. A plan member must also live in the service are for the plan they wish to enroll.

You will not be eligible to enroll in a stand-alone PDP if the Medicare Health plan that you are enrolled in already included prescription drug coverage.

How much Does a PDP Cost?

The monthly premium for your PDP plan can vary depending on the type of plan that you choose to enroll into. The average monthly premium in the US in 2020 is $32.74. In addition to the monthly premium a Medicare beneficiary may also need to pay a Part D deductible and per prescription cost sharing.

Medicare Prescription drug coverage is an optional benefit but if a beneficiary doesn’t enroll into a PDP plan when they are first eligible then they may pay a penalty if they decide to enroll into a plan at a later date. Generally, a beneficiary will pay this penalty for as long as they have prescription drug coverage.

Each plan can have flexibility in the design of their plan formulary. It is critically important to compare your costs associated with each of your prescriptions on each plan to determine what type of drug coverage and what type of plan may be the best fit for your needs.

I am the President of an Orange County sales office with 25 employees. I had the opportunity to meet with Juan Lopez and he helped my wife and I enroll onto a Medicare Supplement Plan F. The premiums for our group plan were costing us $56,000 a year. Juan was able to save us over $38,000 and my wife and I received full coverage with no co-pays or deductibles. We were able to retain a sales position with our savings.

John G

When I first turned 65, I enrolled in Medicare Part B and started paying $50.00/Mo. Since I was still working, I thought that I had to stay on my group plan. Thankfully when I met with Maggie, she helped me compare my options and I decided to leave my group plan and enroll with a Medicare supplement plan. It was very fortunate timing because I received unexpectedly higher medical claims the next year and I was able to save over $10,000 on my Supplement plan with no deductible and lower co-insurance. The biggest bonus was that my firm was able to keep me on payroll for another 4 years since I was able to save them so much money

Sarah K.

I was enrolled on a small group plan with about 30 of my fellow co-workers. It was a small group Gold level plan and it cost my employer around $950 a month. My costs were increasing every year due to my age. I met with Josie and she suggested that I enroll in Part B and enroll in a Medicare Advantage plan. My employer continued to pay for my coverage but Josie was able to save them nearly $800.00/Mo. My Medicare Advantage plan had Zero deductible, $0 co-pays to see my doctor, $0 for my hospital coverage, and much lower maximum out of pocket. My employer was able to save money and this went directly back to providing additional benefits for all of us.

Diane B.

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