Part D

Are covered benefits and cost-sharing requirements under Medicare Part D plans the same? How can I compare?

Although there are some similar features of Medicare Part D plans, they are not all the same. There are several different ways in which plans can differ that could affect your access to medications and how much you pay for them. For example, plans can vary in the lists of drugs they coverage (also known as the plan’s formulary), whether they charge a deductible that you must pay before your coverage begins, the cost-sharing amounts that they charge for specific drugs, and whether patients are required to get prior authorization from their doctor before the plan will cover specific medications. You can compare your plan options and enroll in a drug plan by going to the Medicare Plan Finder, a searchable tool on the Medicare.gov website, or by calling 1-800-MEDICARE (1-800-633-4227). You can also contact the State Health Insurance Assistance Program (SHIP) in your state. SHIPs offer local, personalized counseling and assistance to people with Medicare and their families. You can call 877-839-2675 to get the phone number for the SHIP in your state.

Topics

While we have made every effort to provide accurate information in these FAQs, people should contact the health insurance Marketplace or Medicaid agency in their state for guidance on their specific circumstances.

The Henry J. Kaiser Family Foundation Headquarters: 185 Berry St., Suite 2000, San Francisco, CA 94107 | Phone 650-854-9400
Washington Offices and Barbara Jordan Conference Center: 1330 G Street, NW, Washington, DC 20005 | Phone 202-347-5270

www.kff.org | Email Alerts: kff.org/email | facebook.com/KaiserFamilyFoundation | twitter.com/kff

Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in San Francisco, California.