MyAARPMedicare covers the following prescription drugs (Part D):
- Based on federal standards, the most frequently prescribed medications for Medicare beneficiaries
- A formulary (list of supported drugs) includes brand-name drugs and generic drugs specified by the plan.
- Vaccines that are available commercially that are not covered under Part B
Although certain types of medications must be covered under Medicare Part D, the specific drugs included in their formularies vary by plan. For more information on whether certain drugs are covered, check the formulary of your insurance plan.
Each Part D plan has a drug list, also called a formulary, that tells you which drugs are covered. Depending on your plan, the formulary can change, but you will be notified if it does. In addition, you can find out if there are any special restrictions or limitations associated with your drug in the formulary. Alternatively, your plan will provide you with access to your formulary and drug list online.
Part D plans that are stand-alone require you to pay a monthly premium plus a deductible, copays, and coinsurance. In some plans, there is a deductible; in others, there is not, but Medicare sets a deductible maximum each year.
The annual deductible limit for Part D will be $445 in 2021. Each time you fill a prescription for a covered drug, you generally have to pay a copay. You may need to pay a different amount depending on the plan’s formulary tiers and the pharmacy you use if there are network pharmacies. A few plans may also set drug coinsurance rates or tiers for specific drugs. You will be charged a percentage of the cost each time you fill a prescription under this plan.