Medicare Part D Prescription Drug insurance is optional coverage. To enroll, you must have Medicare Part A and/or Part B. There are several factors you should consider when getting a Part D plan.
On this page you will find:
Other useful links:
Why should I get a Part D Prescription Drug Plan?
- You use prescription drugs on a regular basis
- You think you may need prescription drugs in the future
- You do not have creditable prescription drug coverage (as good as Medicare’s)
- You are worried about increasing prescription drug costs
- You are having trouble paying for your prescription drugs
Not enrolling in a Medicare Part D plan when you are first eligible may result in a lifetime late enrollment penalty. However, you will not incur a penalty as long as you have had “creditable” drug coverage through an employer policy, VA Benefits, or TriCare for Life.
How do I choose a Part D Prescription Drug Plan?
You will want to choose a plan offered by Medicare-approved insurance companies. Find Medicare-approved plans in:
- Your Medicare & You booklet
- The Medicare Plan Finder tool
- Or contact us for assistance
PART D Costs
Your cost for a Part D Plan is going to be different based on the following:
- The drugs you use
- The plan you choose (cost of premium, copayments, deductible)
- Costs of your drugs in the coverage gap (aka “donut hole”)
- Whether you go to a pharmacy in your plan’s network
- Whether the drugs you use are on your plan’s formulary (or list of covered drugs)
In addition to your Part D plan premiums, there is a Part D Income Related Monthly Adjustment Amount (IRMAA) that is paid directly to Medicare.
| Part D Income Related Monthly Adjustment Amount (IRMAA) | ||
|---|---|---|
| 2023 income tax filed in 2024 | 2025 Part D Plan Premium + IRMAA | |
| Individual Tax | Joint Tax | |
| $106,000 or less | $212,000 or less | Premium only |
| $106,001–$133,000 | $212,001–$266,000 | Premium + $13.70 |
| $133,001–$167,000 | $266,001–$334,000 | Premium + 35.30 |
| $167,001– $200,000 | $334,001–$400,000 | Premium + $57 |
| $200,001–$500,000 | $400,001–$750,000 | Premium + $78.60 |
| 501,000 or more | $751,000 or more | Premium + $85 |
Review Your Part D Plan Every Year
Plans may change annually! Plans may change their formularies, and network pharmacies every year and sometimes during the year.
You can change your Part D plan every year during Open Enrollment between October 15 and December 7 to start new coverage beginning January 1.
Evaluate your Part D costs:
- The Medicare Plan Finder on www.medicare.gov
- Free Part D Drug plan comparison through Montgomery County SHIP.