Part D · Prescriptions
Part D: Prescription Drug Coverage in Central Oregon
Learn how Medicare Part D works and what to look for when reviewing your prescription drug options.
Medicare Part D helps cover the cost of prescription drugs. These standalone plans are offered by private insurance companies approved by Medicare and help protect you from high prescription drug costs.
Even if you don't currently take any prescription medications, it's important to understand how Part D works because enrolling late can result in a permanent penalty.
Key Concepts to Understand
The Formulary
A formulary is a list of prescription drugs covered by the plan. Each plan has its own formulary, and it's essential to ensure your specific medications are included on the list.
Drug Tiers
Plans divide their formularies into "tiers" based on cost. Generally, drugs in a lower tier will cost you less than drugs in a higher tier. Tiering structures can vary between plans.
Coverage Phases
Part D coverage has two main phases: a deductible period and an initial coverage phase. Starting in 2025, there is a $2,000 annual out-of-pocket cap — once you hit it, Medicare covers your drug costs for the rest of the year. The coverage gap (donut hole) no longer applies.
Important Considerations
- Why Formulary Review Matters
Because each plan covers different drugs and places them on different pricing tiers, the best plan for you depends entirely on the specific medications you take. Reviewing the formulary helps you estimate your actual out-of-pocket costs.
- Late Enrollment Penalty
If you don't sign up for Part D when you're first eligible, and you don't have other creditable prescription drug coverage, you may have to pay a late enrollment penalty. This penalty is added to your premium for as long as you have Part D coverage.
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.