Medicare Part D is prescription drug coverage offered by private companies approved by Medicare. These companies set the costs for each Medicare Part D plan. Your costs can vary based on your income, the plan you choose and the prescriptions you take.
There are several factors that impact how much you’ll pay with a Medicare Part D plan:
To enroll in Medicare Part D, you must first be eligible for Medicare and enrolled in both Part A and Part B.
Medicare Part A is usually premium-free if you or your spouse worked and paid taxes for at least 10 years.
Medicare Part B has a monthly premium that changes depending on your income.
Each Part D plan has its own monthly premium. This amount varies based on the plan you choose. Some people may also pay an additional cost called IRMAA.
If your income is above a certain level, you may have to pay more each month. This is called the Income-Related Monthly Adjustment Amount (IRMAA).
This amount is not part of your plan’s premium.
It is paid directly to Medicare, usually taken from your Social Security check.
If you must pay IRMAA, you’ll be notified by the Social Security Administration.
You must pay IRMAA to keep your Medicare drug coverage.
Each Part D plan may have a yearly deductible. This is the amount you pay out of pocket before your plan starts covering your prescriptions. Some plans have a $0 deductible.
A copayment is a set dollar amount you pay when you fill a prescription.
Coinsurance is a percentage of the drug’s cost. If the price changes, your cost may change too.
Medicare Part D plans use a formulary — a list of drugs they cover.
Each drug is placed into a tier based on its cost.
Lower-tier drugs usually cost less than higher-tier ones.
If your medication isn’t on the formulary, your doctor may recommend an alternative or request an exception.
To get the most from your Part D prescription drug plan, fill your prescriptions at an in-network pharmacy.
Many Medicare Advantage plans and Part D plans offer mail-order pharmacy options.
Using out-of-network pharmacies may result in higher costs.
You may face an enrollment penalty if you:
Don’t enroll in a drug plan when first eligible for Medicare
Have a gap of 63 days or more without creditable prescription drug coverage
This enrollment penalty is added to your Part D premium and lasts as long as you have Medicare.
If you owe IRMAA, Medicare will bill you directly. You must pay it to keep your Medicare drug coverage.
Ways to pay IRMAA: Medicare online account Medicare Easy Pay (bank account auto-draft) Your bank’s bill pay system Mailing a check to Medicare Ways to pay your Part D premium: Deducted from Social Security or retirement benefits Online through your plan’s payment system Auto-pay from your checking or savings account Mail a payment Pay with Health Savings Account (HSA) funds (if eligible)
Help with Medicare Part D costs If you have a limited income, prescription savings programs or other support may help lower your costs. You may qualify for Extra Help or other cost assistance programs. We’re here to help you understand your options and find the right plan. Contact Banner Medicare Advantage at 833-516-1007, TTY 711. October 1 – March 31: 8 a.m. to 8 p.m., seven days a week April 1 – September 30: 8 a.m. to 8 p.m., Monday through Friday
Questions about Medicare Part D?
Have questions or need help enrolling?
Call 833-516-1007, TTY 711, to speak with a licensed sales agent.
October 1 – March 31: 8 a.m. to 8 p.m., seven days a week
April 1 – September 30: 8 a.m. to 8 p.m., Monday through Friday
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