Medicare Part D Prescription Drug Coverage

Prescription drugs are an important part of health care. A Walgreens pharmacist will walk through Medicare Part D prescription drug coverage—the basics, how to get Part D, enrollment and key tips. We'll also walk through some important things you may not know, offer tips for how your pharmacist can help and more.

Video transcript

Soft guitar music plays with a steady drumbeat. A navy-blue logo of overlapping Us is centered on a white background. The lines of the logo unfurl and weave over the screen, creating a blue background. Two speech bubbles pop up on the top right, a small turquoise bubble next to a larger white bubble with blue text inside.

ON SCREEN TEXT: Part D

Coverage

Large white text is in the bottom left.

ON SCREEN TEXT: Medicare

Conversations

The words and speech bubbles disappear upwards, and the silhouette of a white pill bottle appears on the left with a turquoise lid sitting next to it. White text is to the right.

ON SCREEN TEXT: What to know about

Larger text is underneath.

ON SCREEN TEXT: Medicare prescription

drug coverage

Yellow-orange medicine capsules tumble into the pill bottle. Two miss the bottle and land next to it.

The screen swipes right and now a middle-aged white man with brown eyes and gray hair gelled into a centered tip sits in a white room wearing a light blue plaid button-up. In the background, a teacup sits on a book next to a potted plant on a drawer unit. A mirror hangs on the wall. A blue banner pops in from the bottom left with white text.

ON SCREEN TEXT: Mike Umbleby

Smaller text is underneath.

ON SCREEN TEXT: Licensed pharmacist

The banner folds away.

Mike: Hi there. I'm Mike Umbleby, a licensed pharmacist with over 25 years with Walgreens. Walgreens is committed to championing the health and well-being of every community in America. That's why we're excited to partner with Medicare Made Clear, brought to you by UnitedHealthcare, to talk about Medicare Part D prescription drug coverage.

On a blue background, a yellow hand with a turquoise cuff peeking out from a white sleeve is put up from the bottom left. Large white text is to the right.

ON SCREEN TEXT: What topics are we going to cover today?

Back in the white room with Mike.

Mike: So today we’re going to cover the basics of Medicare Part D coverage: how to get it, how to enroll, and some things you might need to know.

On a white background, an orange pill bottle with a white lid and label appears in a blue circle on the left. Blue text is underneath.

ON SCREEN TEXT: The basics of

Part D

A turquoise magnifying glass with a yellow handle appears in a blue circle in the middle with blue text underneath.

ON SCREEN TEXT: How to get

Coverage

A white calendar with an orange checkmark on one of the dates appears in a blue circle. Blue text appears underneath.

ON SCREEN TEXT: How to enroll

With Mike in the white room.

Mike: We’ll also talk about some tips and tricks that might be helpful.

On a blue background, the white bottle of orange and yellow pills appears again next to the white text.

ON SCREEN TEXT: What is Medicare

Part D coverage?

In the white room, Mike speaks.

Mike: Alright, let’s go ahead and get started. The Medicare Part D is Medicare prescription drug coverage.

The screen is split down the middle. On the left is an orange pill bottle with a white lid and label on a blue background. White text is under the bottle.

ON SCREEN TEXT: Plan A

Seven pills are underneath, three bi-colored capsules in yellow and orange or white and turquoise, and four tablets in turquoise, white, or yellow.

On the right is an identical pill bottle with blue text under it on a pale blue background.

ON SCREEN TEXT: Plan B

Five pills are under it, two yellow and orange capsules, two turquoise tablets, and an orange tablet.

Mike: Prescription drugs that are covered vary by plan, but all Medicare Part D plans must meet the same guidelines set by the federal government.

Both sides lower as a white stripe appears above them. A turquoise outline of mainland America is in a blue circle and blue text is underneath.

ON SCREEN TEXT: Federal guidelines

Four pills are underneath it, two orange and yellow capsules and two turquoise tablets.

On a blue background, a white piece of paper has an image of an orange and yellow tablet at the top and lines of turquoise text. White text appears next to the paper.

ON SCREEN TEXT: What is a

formulary?

Mike talks in the white room.

Mike: The formulary is a list of drugs, includes both brand and generic drugs, and varies from plan, as well as provider.

On the blue background, the paper appears on the left again with white text above it.

ON SCREEN TEXT: Formulary.

On the right, two capsules appear. An orange and yellow capsule has white text next to it.

ON SCREEN TEXT: Brand

Below it, a turquoise and white capsule has white text next to it.

ON SCREEN TEXT: Generic

In the white room, Mike speaks.

Mike: But your pharmacists can work with you to determine which drugs are covered or not covered under your specific Part D plan.

The Formulary paper appears on the left of a blue background again and large white text is on the right.

ON SCREEN TEXT: Can plans make changes to the formulary?

With Mike.

Mike: When Part D plans change a formulary, they may either add or remove prescription drugs from the formulary.

On the blue background, the paper appears on the left again with white text above it.

ON SCREEN TEXT: Formulary.

On the right, four pills appear: A white tablet, an orange and yellow capsule, a turquoise and white capsule, and a turquoise tablet.

Now the white tablet disappears.

In the white room.

Mike: Usually the formulary changes on a yearly basis. Your Part D plan will notify you if they change the formulary.

In the middle of a blue background, a white paper appears with a blue circle on it. In the circle is a white warning triangle with a turquoise exclamation mark.

In the room with Mike.

Mike: Another reason a drug might come off the formulary is if it’s removed from the market. Again, your plan will notify you and you can work with your doctor or pharmacist.

On a blue background, white text appears on the right.

ON SCREEN TEXT: What drugs does

Part D cover?

A yellow and orange capsule falls and lands on the left.

Mike speaks.

Mike: Part D plans do not cover all drugs. For example, they do not cover drugs that are not on the formulary, drugs that are already covered under Medicare Part A or Part B, non-prescription drugs, prescription vitamins and minerals, as well as drugs for weight loss, erectile dysfunction, anorexia, hair loss, etc.

On a blue background, a large white title appears centered at the top.

ON SCREEN TEXT: Part D does not cover:

Smaller text appears below in point form with orange Xs as the points.

ON SCREEN TEXT:

· Drugs not on a plan formulary

· Drugs already covered by parts A or B

· Non-prescription drugs

· Prescription vitamins and minerals

· Drugs for weight loss, erectile dysfunction, anorexia, hair loss, etc.

Mike speaks in the white room.

Mike: But formulary also consists of tiers of drugs.

On a white background, a triangle appears divided into three layers. The bottom layer is blue with a white tablet, a turquoise and white capsule, and a turquoise tablet in it. The middle layer is turquoise with an orange and white capsule and a yellow tablet inside. The tip is pale blue with an orange and yellow capsule in it. On the right, dollar signs appear next to each layer; one at the blue layer, two at the turquoise layer, and three at the pale blue layer.

Mike: Those tiers are usually determined by cost and include both generic and brand name medication.

Back with Mike in the room.

Mike: So your doctor or pharmacist can determine which tier and which medication is right for you.

On the blue background, a yellow hand descends from above and picks up an orange pill bottle with a white lid and label. Large white text is to the right.

ON SCREEN TEXT: How do I get Part D coverage?

Mike sits in the white room.

Mike: The two ways to get prescription drug coverage through Medicare are: one, as a standalone Part D plan, or two, as part of a Medicare Advantage plan that also includes prescription drug coverage.

The silhouette of a white pill bottle appears next to its turquoise lid on a blue background. Yellow-orange medicine capsules tumble into the pill bottle. Two miss the bottle and land next to it. A white circle appears to the right with a blue number inside.

ON SCREEN TEXT: 1

Large white text is below it.

ON SCREEN TEXT: Stand-alone

Part D

The background turns pale blue, and the circle turns blue with a white number.

ON SCREEN TEXT: 2

The text also changes and turns blue.

ON SCREEN TEXT: Medicare

Advantage Plan

Mike talks in the room.

Mike: It's important to differentiate between the two. A standalone Medicare Part D plan includes prescription drug coverage only. A Medicare Advantage plan with prescription drug coverage is a comprehensive plan that includes Medicare Part A and Part B benefits, prescription drugs, as well as other healthcare services such as hearing, dental, vision, or fitness.

A pale blue circle pulses outward on a white background, revealing blue text in the center.

ON SCREEN TEXT: Medicare

Advantage

In the pale blue circle, a blue circle appears above the text with a white bed silhouette and blue text underneath.

ON SCREEN TEXT: Part A

To the bottom left of the pale blue circle, a blue circle with a turquoise stethoscope appears with blue text under it.

ON SCREEN TEXT: Part B

On the bottom right of the pale blue circle, a third blue circle appears with a turquoise pill bottle inside. The label on the bottle has a blue RX logo on it. Blue text is under the blue circle.

ON SCREEN TEXT: Part D

On a blue background, a white circle appears in the center with a yellow ear inside. White text appears above it.

ON SCREEN TEXT: Hearing

The image moves into the top left as the screen is split into quarters. On the top right are blue glasses on a white background, with blue text above it.

ON SCREEN TEXT: Vision

On the bottom left is the head of a blue toothbrush on a white background with blue text above it.

ON SCREEN TEXT: Dental

In the bottom right is a gym back with an orange shoe and yellow water bottle peeking out the top, and orange swimming goggles next to the bag. White text is above the image.

ON SCREEN TEXT: Fitness

Mike appears for a moment.

Mike: So standalone Part D plans can work with Medicare Part A and B, some Medicare supplemental insurance plans, as well as certain Medicare Advantage plans.

On a blue background, large title text appears along the top.

ON SCREEN TEXT: Part D can work with:

Four white circles appear in a row with simple blue graphics in each. The first has a bed, the second has a stethoscope, the third has an umbrella, and the fourth has both a bed and stethoscope. White text appears under each of the white circles.

ON SCREEN TEXT: Part A

Part B

Medicare supplement insurance

Medicare Advantage

Back with Mike.

Mike: You can sign up for a standalone Part D plan by purchasing directly from a private insurance provider.

Large blue text appears on a white background.

ON SCREEN TEXT: Purchase directly

from a private

insurance provider

Mike sits in the white room.

Mike: This will be separate from enrolling in Medicare Part A or B.

A row of three blue circles appears on a white background. In the first circle is a white dollar sign, in the second is a graphic of a bill, and in the third is a pie chart split into two white thirds and one larger turquoise third. Blue text is under each circle.

ON SCREEN TEXT: Premium

Deductible

Copay or coinsurance

Mike: You will have a premium and a deductible to pay. You may also have a copay or coinsurance when filling some prescriptions.

A turquoise magnifying glass with a yellow handle appears on the left of a blue background. Large white text pops up on the right.

ON SCREEN TEXT: Are there

other things I

should know?

Mike talks in the room.

Mike: Here are some important things you need to know for Part D plans. Number one, some plans may offer mail order service.

A row of three more blue circles appears on a white background. In the first is a white envelope, in the second are three white dots connected in a circle by curved turquoise lines, and in the last are three bars organized from left to right starting with the shortest to the tallest, with the tallest being turquoise while the other two are white. Blue text is under each circle.

ON SCREEN TEXT: Mail order services

Pharmacy networks

Step therapy

Mike: Two, some plans may have a specific network of pharmacies, while others offer nationwide coverage. And three, some plans may require step therapy for certain drugs.

On a blue background, the calendar is on the left and a page of it flips back, then an orange checkmark appears on one of the dates. Large white text is on the right.

ON SCREEN TEXT: When do I need to enroll in a Part D plan?

In the room with Mike.

Mike: So let’s talk about when you enroll in Medicare Part D, because when you enroll will determine when your coverage starts.

A birthday cake slides in on a pale blue bar split in seven sections, sitting on the fourth section in the middle. A paper with an orange checkmark appears over the second section with small blue text over it.

ON SCREEN TEXT: Enrollment

The four sections of the pale blue bar from the cake onward turn turquoise for a second.

Mike: If you enroll before your birthday month, then coverage will begin on the first day of your birthday month.

The bar returns to pale blue and the enrollment paper disappears, reappearing on the sixth section on the other side of the cake. Now only the seventh section of the pale blue bar turns turquoise.

Mike: If you enroll after your birthday month, then coverage will start on the first day of the month following the date you enroll.

Mike is in the white room.

Mike: Most people will enroll in Medicare Part D when they first sign up for Medicare during their initial enrollment period.

Now the birthday cake is in the center of the white background and the pale blue bar appears behind it, still split into seven sections. Large blue text appears at the top of the screen.

ON SCREEN TEXT: Initial Enrollment Period

Small blue text appears below the large text.

ON SCREEN TEXT: 7 months

Mike talks in the white room.

Mike: Some people are able to delay enrolling in Medicare Part D because they are working past 65. This group is able to do this because they qualify for a special enrollment period due to having other creditable drug coverage.

Blue text appears at the top of a white background.

ON SCREEN TEXT: Medicare Part A and Part B

Special Enrollment Period

Smaller blue text is underneath.

ON SCREEN TEXT: 8 months

Below that is a pale blue bar now split into eight sections. A yellow and orange capsule appears on each of the first two sections which then turn turquoise. Blue text appears under them.

ON SCREEN TEXT: Medicare

Part D

Mike is in the room.

Mike: You may not be taking prescription drugs when you're ready to enroll, but it might be a smart move to get Part D coverage to avoid late enrollment penalties down the line.

The birthday cake is in front of the pale blue bar split in seven on a white background. The cake slides left offscreen and the bar slides left, stopping with the last two sections in the middle of the screen as they turn orange. Yellow coins float out of the orange sections and small blue text appears above.

ON SCREEN TEXT: Penalties

Mike talks in the room.

Mike: Medicare Part D coverage is only available through private insurance providers. You will need to sign for Medicare Part A or Part B separately.

Now the screen is split down the middle. On the left is a card on a blue background with white text on it.

ON SCREEN TEXT: Medicare

Under the card is white text.

ON SCREEN TEXT: Medicare

Parts A & B

On the right is the while bottle of orange and yellow pills and blue text under it.

ON SCREEN TEXT: Medicare

Part D

Orange checkmarks appear, one over the card and another over the pill bottle.

In the room, Mike speaks.

Mike: And with Part D, the plan you choose will continue automatically each year, unless you choose to change plans, or your plan provider no longer offers that plan.

On a white background, a blue bar is split into twelve which are labelled with three-letter abbreviations of the months. The blue bar is in a pale blue rectangle and moves to the left showing the beginning of a second blue bar of months, this time outside of the pale blue rectangle. An orange checkmark appears above the January section of the second bar and the pale blue rectangle extends to encompass the second bar.

Mike sits in the white room.

A white piggy bank appears on the left of a blue background and large white text appears on the right.

ON SCREEN TEXT: What are the costs for a Part D plan?

Yellow coins appear next to the piggy bank.

Mike talks in the white room.

Mike: While costs and prices will vary by plan, when it comes to paying for Part D, you will be responsible for a premium, a deductible, copay, or coinsurance.

ON SCREEN TEXT: Premium

Deductible

Copay or coinsurance

Back to Mike.

Mike: Some plans charge an annual deductible, but not all do.

On a blue background, nine dark rings are in a row along the top. Underneath, a white piggy bank appears on the left with white text under it.

ON SCREEN TEXT: Deductible

Two yellow coins rise from the piggy bank’s slot and fill the first two rings. A thin yellow line appears between the coins and the empty rings.

Mike: Deductibles are set amounts you pay out of pocket for covered services before Medicare or your plan begin to pay.

A yellow piggy bank and a turquoise piggy bank appear after the white piggy bank. White text appears under them both.

ON SCREEN TEXT: Medicare and/or

private Medicare plan

With Mike in the room.

Mike: Plans may also charge deductibles for certain drugs and not for others. Deductibles can also vary from plan to plan, or from one drug tier to another.

Now two white papers appear next to each other on a blue background. Each has blue text on it.

ON SCREEN TEXT: Plan 1

Plan 2

A yellow coin appears over the Plan 1 paper, and three yellow coins appear over the Plan 2 paper.

With Mike for a moment.

Mike: However, Medicare does set a maximum deductible amount that Part D plans can charge each year.

Now the row of nine dark rings is in the center of the blue background. Three coins rise from below to fill the first three rings and a thin yellow line appears to separate the coins from the six empty rings. White text appears above the line.

ON SCREEN TEXT: Part D

maximum

deductible

Now the nine empty rings are at the top of the blue background. A white piggy bank appears underneath with white text under it.

ON SCREEN TEXT: Copay/coinsurance

Two yellow coins rise from its slot and fill the first two rings. A thin yellow line appears to separate them from the empty rings.

Mike: There may be a copayment or copay for any new and refill prescriptions, although some plans may not charge a copay for a prescription.

Back with Mike.

Mike: Copays are a fixed amount that you pay for a covered service, and, in this case, for a prescription.

On a blue background, a large yellow coin rises on the left and large white text is on the right.

ON SCREEN TEXT: What are the four

Part D cost stages?

Mike speaks in the room.

Mike: So now let’s talk about the four cost stages of Medicare Part D. The four coverage stages are annual deductible, initial coverage, coverage gap, and catastrophic coverage.

Blue text appears on a white background.

ON SCREEN TEXT: 1. Annual deductible

Under it is the first section of a pale blue bar.

The text scrolls up out of sight and is replaced by more blue text.

ON SCREEN TEXT: 2. Initial coverage

A second section of the bar appears in turquoise.

The text scrolls away again, replaced by more.

ON SCREEN TEXT: 3. Coverage gap

A third section of the bar appears in blue.

The text scrolls away and more text replaces it.

ON SCREEN TEXT: 4. Catastrophic coverage

A fourth and final section appears on the bar in orange.

Back with Mike in the room.

Mike: In the annual deductible stage, you pay for your prescriptions until you reach your plan deductible.

Blue text appears on a white background.

ON SCREEN TEXT: 1. Annual deductible

A pale blue section of a bar appears below, and three coins lower from it, stopping in a row underneath.

Mike sits in the white room.

Mike: If your plan doesn’t have an annual deductible, then your coverage starts with the first prescription you fill, and you are now in the initial coverage stage.

Now the blue text on the white background is replaced.

ON SCREEN TEXT: 2. Initial coverage

A turquoise section extends from the pale blue section of the bar and a single coin lowers from it, stopping underneath it.

Mike: In the initial coverage stage, you pay a copay or coinsurance, and the plan pays the rest.

With Mike.

Mike: You stay in this stage until your total drug costs reach the initial coverages annual limit set by Medicare. Once you reach that limit, you now enter the coverage gap stage, also known as the doughnut hole.

The blue text on the white background is replaced again.

ON SCREEN TEXT: 3. Coverage gap

The bar slides over as a blue section extends from the turquoise end. Small blue text appears next to the larger blue text.

ON SCREEN TEXT: (The Donut Hole)

Mike: In the coverage gap stage, you pay a bigger share of the costs for your prescriptions than you did before. This means you pay 25% of the cost for both brand name and generic drugs.

Two coins descend from and stop under the blue section of the bar. The existing blue text rises as smaller blue text appears under the text and above the bar.

ON SCREEN TEXT: You pay 25% for all drug coverage.

Back with Mike.

Mike: And you stay in this stage until your total out of pocket costs reach the coverage gap stage’s annual limit. The limits to enter and exit the coverage gap are set by Medicare, and these amounts can change every year.

Now the blue text and bar rise until the blue text is out of sight and the partially concealed bar is at the top of the white background. Under the final two coins is small blue text.

ON SCREEN TEXT: Coverage gap annual limit

Seven dark rings are underneath. The coins under the bar and from offscreen float down and line up above the rings, then descend to fill the empty rings.

Mike speaks in the white room.

Mike: Catastrophic coverage is the final stage you could go through for prescription drug costs.

Now the bar of the pale blue, turquoise, and blue sections extend from the left of the white background under large blue text.

ON SCREEN TEXT: 4. Catastrophic coverage

An orange section extends from the blue section of the bar.

Mike: In this stage, you pay a small copay or coinsurance amount.

In the room with Mike.

Mike: You will then stay in this stage for the remainder of the plan year.

Now a four-sectioned bar of light blue, turquoise, blue, and orange unfurls to the right on the white background above the blue twelve-sectioned bar of months which unfurls rightward as well. The view slides with them, stopping at the ends where the first halves of the bars are offscreen to the left.

Mike: The coverage stage cycle starts over again at the beginning of the plan year, usually January first.

Second copies of each bar start to appear next to them, the view following along until the second two bars are seen in their entirety, centered on the screen. The very ends of the first two bars can be seen on the left.

Now large white text appears on the right of a blue background.

ON SCREEN TEXT: Is there financial assistance for Medicare Part D?

On the left, an orange hand extends from offscreen and a coin falls into it.

Mike sits in the room.

Mike: There is financial assistance available for Part D. For those that qualify, the extra help program may cover some or all Medicare Part D costs.

On a white background, a blue circle appears next to blue text.

ON SCREEN TEXT: Extra Help

Program

A white hand is in the circle with a turquoise heart in its palm.

Back with Mike.

Mike: Other financial assistance options may be available, depending on the state that you live in.

Blue text appears on a white background. Small text is at the top.

ON SCREEN TEXT: Other options include:

Larger text follows.

ON SCREEN TEXT: State Pharmaceutical

Assistance Programs

(SPAPs)

Mike: This includes state pharmaceutical assistance programs, or patient assistance programs.

The large text is replaced.

ON SCREEN TEXT: Patient Assistance

Programs (PAPs)

In the white room.

Mike: If you are a veteran, you may be eligible for benefits through the VA, so it's important to compare both VA benefits, as well as Medicare, to see what you do or do not need, or how the two can work closely together.

A clipboard appears on the left of a blue background. Large white text is on the right.

ON SCREEN TEXT: Do you have any

useful tips or tricks?

An orange checkmark appears on the clipboard.

Mike sits in the white room.

Mike: Here's some tips to help you save money with your Part D plan. Talk to your doctor or pharmacist about any low cost or generic substitutes to replace expensive medications that you may be taking.

Now a graphic of a person appears on the left of a blue background. They are wearing a white coat over turquoise scrubs and a mask, with an orange stethoscope around their neck. Small white text appears to the right.

ON SCREEN TEXT: Talk to your doctor

or pharmacist

In the room with Mike.

Mike: Also, think about talking to your pharmacist about a 90-day supply.

A three-sectioned turquoise bar appears on a white background and a yellow and orange capsule appears in front of each section. Blue text appears under the bar.

ON SCREEN TEXT: One 90-day supply.

Mike: This costs less per dose than a typical 30 day supply of medication.

The image and text moves left as a blue background takes over the right side of the screen. On that side, three single-sectioned turquoise bars appear in a row, each with a yellow and orange capsule in front of it. White text is underneath.

ON SCREEN TEXT: Three 30-day supplies

On the left side, five coins appear in a row above the three-sectioned bar. On the right side, two coins appear over each of the three single-sectioned bars.

Mike is in the room.

Mike: Also, check with your plan to see if they have a preferred pharmacy network.

On a white background, a blue circle appears on the left with three white dots inside. A turquoise line curves inside, connecting the dots in a circle. Blue text is on the right.

ON SCREEN TEXT: Check if your plan has a preferred pharmacy network.

Mike: Copays are usually less when you have them filled at a preferred pharmacy.

A white circle now appears on a blue background with a blue question mark inside it. Large white text is on the right.

ON SCREEN TEXT: Where do I go

from here?

Back in the room with Mike.

Mike: If you're ready to explore Medicare Part D prescription drug plan options, click on the link, and thank you for watching.

Blue text appears in the center of a white background.

ON SCREEN TEXT: Medicare Made Clear

brought to you by UnitedHealthcare

The music crescendos. The text disappears as a ribbon of blue lines weaves in and becomes the logo of overlapping letter Us in the center of the screen. The logo fades into blue text.

ON SCREEN TEXT: United

Healthcare

Tiny grey text appears along the bottom of the screen.

The grey text fades with the last few strums of guitar music.