MEDICARE PRESCRIPTION DRUG PLANS (Part D)
What are Medicare Part D (Prescription Drug Plans)?
- Helps lower the cost of prescription drugs
- Offered by insurance companies that are approved by Medicare

Which Drug Plan Is Right For Me?
- The drug plan with the lowest premium does not necessarily equate to lowest annual total cost
- Medicare Sharks will help you find the best drug plan that fits your needs and budget according to your specific prescription drug list
- Every drug plan has a different premium along with a deductible and copays
- Each drug plan has a different list of drugs that are covered under their “Formulary & Tiers”
- Your actual drug plan costs will vary depending on factors such as the drugs you use, the plan you choose, the pharmacy you use, whether the drugs you use are on your plan’s formulary, etc.
- Call Medicare Sharks to discuss your regular prescription list and we will do a quick-search to compare every drug plan’s formulary to find the best overall option that will provide the lowest annual total cost.
Let Medicare Sharks do the hard work for you!

How Do I Reduce My Drug Costs?
- Talk to your doctor about prescribing lower cost alternatives when possible.
- Use generics and over-the-counter options as an alternative to brand name medications.
- Use your plan’s preferred pharmacy network or use your plan’s mail-order pharmacy and refill medications for a 90-day supply.
- Use free discount program cards/coupons such as www.GoodRx.com
- Research a specific drug manufacturer’s Prescription Assistance Program
Plans may have coverage rules for certain drugs:
If you or your prescriber believe that your plan should waive one of these coverage rules, you can ask for an exception.
We can help you decide! Call us now
Understanding Drug Payment Stages & "Donut Hole"

Deductible Stage
During this stage, if your plan has a deductible, you usually pay the full discounted cost up to the deductible amount for drugs listed in Tiers 3,4, and 5 of your formulary. (Drugs in Tiers 1 and 2 don't have a deductible because they generally cost less. Your copayment for these drugs will be the same whether you have met the deductible or not.)
Once you reach the deductible amount, you pay a copayment or coinsurance in the initial coverage stage.

Initial Coverage Stage
During this stage, you pay a copayment or coinsurance (your share of the cost) for the discounted price of each prescription you fill until your total drug costs (what you and your plan pay) reach $4,430.
Once you satisfy $4,430, you enter the coverage gap or "donut hole."

Coverage Gap or "Donut Hole" Stage
During this stage, your discount is less because you'll be receiving a minimum level of coverage on brand-name and generic drugs until your yearly out-of-pocket costs reach $7,050.
Once your yearly out-of-pocket costs reach $7,050 you move to the catastrophic stage.

Catastrophic Coverage Stage
In this stage, most members will pay only a small copayment or coinsurance amount for each prescription.

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