Drug Coverage

Part D drug coverage is only available from private companies contracted with Medicare.

You usually choose Part D drug coverage in one of two ways:

1. A separate “stand alone” drug plan and then you buy a separate Medicare Supplement Policy

2. Or you can get your part D drug coverage as part of a Medicare Advantage plan.

How the Part D drug plan works:

The term “Formulary” is a list of medications that the Part D drug plans or Medicare Advantage plans covers.

Note: ALL drug plans are not the same. You need an agent that will run your drug list based on the specific medications you are taking.

Give us a call. The Gary Smith Agency will be happy to run your drug list.

Drug Plan Stages

Stage One

Deductible Stage:

Most plans have an annual deductible. But the deductible may not apply to all drug tiers. See the plan summary for details.

Stage Two

Initial Coverage Stage:

In this stage you pay a co-pay or a percentage of the drugs total cost. The plan pays the rest.

You will stay in this stage until you use all the benefits in this stage.

Most people never leave Stage Two but once the benefit is used up, it is gone for that year.

Once the Benefit is used up in Stage Two, you move to Stage Three.

Stage Three

Donut Holes:

In this Stage, you will pay 25% of the retail cost for your drugs. If your drug cost $100.00, your copay will be 25% or $25.00. Once the Benefit is used up in Stage Three, you move to Stage Four.

Stage Four

Catastrophic Stage:

This stage is the light at the end of the tunnel. You will pay a small copay or co-insurance amount. You will stay in this stage for the rest of the plan year.

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