Best Medicare Prescription Drug Plans

Quick Answer: Best Medicare Prescription Drug Plans

• Best Overall for Prescription Drug Plan: easyMedicare
• Cheapest for Prescription Drug Plan: Aetna
• Best for Customer Service: WellCare
• Best for Coverage Network: Humana
• Best for Drug Inclusion: UnitedHealthcare

Many new Medicare policyholders are surprised to learn that neither Medicare Part A or Medicare Part B offers coverage for outpatient prescription drugs. Adding a Medicare prescription drug plan to your Original Medicare enrollment can help you pay for some of the most common prescriptions not covered by parts A and B.

Best Medicare Prescription Drug Plans and Providers

We’ve compiled a list of the best Medicare prescription drug plans and providers to make your search easier. Our top picks offer comprehensive coverage at affordable rates and deliver exceptional customer service. 

Refer to the formulary (or list of covered drugs) to confirm the medications you need are covered. Medicare requires that policies cover at least 2 drugs in the most common classes and categories. So if your specific drug is not listed, there’s probably a similar option. 

Don’t forget to review anticipated costs and copayments to ensure the plan works for your budget. 

1. Best Overall: easyMedicare

The aptly named easyMedicare makes Medicare — you guessed it — simple. easyMedicare's licensed sales agents provide personalized one-on-one help to guide you through your available plan options and discuss your healthcare insurance needs. Its licensed sales agents can guide you to choose the best plan for you.

Just enter your ZIP code and you can compare plans easily in your area. easyMedicare.com lets you shop many of Medicare’s respected health insurance carriers: Humana, UnitedHealthcare, Cigna-HealthSpring, Aetna, Wellcare and others.

2. Most Affordable Prescription Drug Plan: Aetna

Aetna, now part of CVS, is worth considering if you’re on a fixed income. Its affordable SilverScript Part D plans have low premiums and copayments that make it easier to get the drugs you need without stretching your budget too thin. 

You’ll spend around $7 to $10 in monthly premiums for SilverScript Choice (PDP) plans and $70 to just over $100 in premiums for SilverScript Plus (PDP) plans on average. 

Plans feature an array of generic and brand-name drugs with no deductible. You’ll also enjoy $0 copayments on Tier 1 drugs when you fill your prescriptions at preferred retail pharmacies. 

3. Best for Customer Service: WellCare

WellCare specializes in Medicare Advantage and Medicare prescription drug plans. WellCare can help you select the best plan for your prescription drug needs.

It currently serves over 15 million customers in 32 states and it’s committed to offering top-notch service so you can stay healthy. 

4. Best for Coverage Network: Humana

Looking for a provider that offers an extensive coverage network? Consider an affordable Medicare prescription drug plan from Humana. 

Humana offers 3 Part D plans to choose from: 

• Humana Basic R Plan (PDP) provides copayments between $0 and $1 on covered generic drugs once you’ve met your deductible.
• Humana Premier Rx Plan (PDP) features no deductibles or copays on 90-day supplies of Tier 1 and Tier 2 drugs. 
• Humana Walmart Value Rx Plan (PDP) offers a premium of only $13.20 per month and enables you to save a bundle on covered generics at Walmart and Sam’s Club pharmacies.

Humana also extends coverage for deliveries so you can get the medications you need without leaving your home. You may be eligible to participate in the Medication Therapy Management (MTM) program if you take multiple medications prescribed by several providers. 

5. Best for Drug Inclusion: UnitedHealthcare

The AARP MedicareRx Walgreens plan covers an array of generic and brand-name drugs. You won’t have copayments on prescription drugs and no deductible on both Tier 1 and 2 drugs. You may also be eligible for $15 cost savings or more on select prescriptions. An AARP membership isn’t required to qualify for coverage. 

This plan is most ideal if you live near a Walgreens because you’ll have to fill your prescriptions there. Use Walgreens’ online store finder to find a location near you. 

What is a Medicare Prescription Drug Plan?

Medicare prescription drug plans (commonly known as Medicare Part D) are plans offered by private insurance companies that extend your insurance to cover a wide array of drugs and medications not covered by Medicare parts A or B. In most cases, Original Medicare will provide coverage for any medications you receive within an inpatient care setting (like a hospital) but will not extend to outpatient drugs such as antidepressants that you pick up from your local pharmacy.

Medicare Part D plan providers are authorized by the federal government and are required to provide you with a set list of benefits. Medicare Part D plans are optional if you have Original Medicare coverage but can offer crucial savings if you take prescriptions at home. If you have a Medicare Advantage plan, you may already have prescription drug coverage. Many Medicare prescription drug plans are available, so it’s important to take your time when selecting the best option for your needs. 

How do Medicare Prescription Drug Plans Work?

It’s helpful to know that there are 4 main components to Medicare: 

• Medicare Part A: Hospital insurance
• Medicare Part B: Medical insurance
• Medicare Part C: Medicare Advantage that merges Part A and Part B
• Medicare Part D: Prescription drugs

Medicare prescription drug plans supplement Original Medicare plans, Medicare Supplement insurance and, in some cases, a Medicare Advantage plan because some don’t offer prescription drug coverage. Drug plans generally offer 4 tiers of coverage to make drug costs more affordable (and sometimes even free):

• Tier 1: Generic prescription drugs 
• Tier 2: Preferred, brand-name prescription drugs
• Tier 3: Non-preferred, brand-name prescription drugs
• Specialty tier: High-cost prescription drugs

The higher tiers typically mean you’ll face more expensive copayments or costs. You may qualify for a lower copayment for medications in a higher tier if you file an exception with your provider or if the actual drug company offers some options.

Professionally-administered drugs may be covered under Original Medicare or Medicare Part A and B but the prescription drug plans can help you save even more money on prescriptions. 

Quick note: If you’re currently enrolled in a Medicare Advantage plan that offers prescription drug coverage, the provider will terminate your policy if you join a Part D plan. Most Medicare Advantage policies include coverage for prescription drugs, so it wouldn’t make sense to carry both. 

If you don’t have adequate prescription drug coverage or are paying out of pocket, a Medicare Part D plan is definitely worth considering. Medicare Supplemental Insurance (or Medigap) won’t help offset prescription drug costs — it only works with Part A and Part B plans. 

When you enroll in a Medicare prescription drug plan, you’ll go through 4 stages of coverage as you use your benefits. The percentage of your prescriptions that your Part D plan will cover varies depending on the stage you’re in.

• Annual deductible: Like most other types of insurance plans, Medicare prescription drug plans have an annual deductible you must pay for out of pocket before your insurance kicks in and starts providing coverage. For 2021, the maximum allowable deductible is $445. While plans may charge less than this amount, they cannot set a deductible higher than $445.
• Initial coverage: After you’ve met your deductible, you’ll enter into the initial coverage phase. During this phase you will pay a copay for each prescription you need based on your policy’s formulary. For example, a generic medication in Tier 1 might come with a copay of $9 while the generic drug’s name-brand version carries a copay of $55.

You’ll continue on the initial coverage phase until you and your insurance company combined have spent a total of $4,130 in 2021. Your insurance company that you bought your Part D coverage from will keep track of your spending, but you should also keep your receipts for your records.

Coverage gap: After you and your insurance company spend $4,130 within a year, you’ll enter the coverage gap phase. During this phase, you will pay 25% of the retail price of your prescription drugs, regardless of their cost. Your insurance company will cover the remaining 75%.

The coverage gap phase continues until you spend a total of $6,550 in 2021. Keep in mind that the insurance company will not count what it spends toward this upper limit — it will calculate your spending based on deductibles and copays only. Likewise, Part D plan providers will not include any contributions that the federal government provides on your behalf into your total spending.

Catastrophic coverage: After you’ve reached the end of your coverage gap, your insurance provider will pay 95% of the costs of your prescription medication until the end of the year.

Keeping careful track of your spending can help you avoid accidentally paying more for your prescriptions than you have to.

How to Sign Up for Medicare

If you’re currently collecting Social Security, you will be automatically enrolled in Medicare Part A and Part B. You must be collecting Social Security benefits at least 4 months before your 65^th birthday in order to be automatically enrolled in Original Medicare. If this is your situation, you will receive your Medicare card in the mail 3 months before you turn 65.

If you will not be collecting Social Security benefits for at least 4 months before you turn 65, you will need to manually enroll in Medicare Part A and Part B. You can view the steps you’ll need to take and the forms you’ll need to complete to manually enroll in Original Medicare on the Social Security website here. 

If you delay Medicare enrollment because you have employer-sponsored insurance, you should remember that there could be penalties involved once you finally enroll and the circumstances under which you enroll. If you enroll and retain your employer-sponsored insurance, remember that one policy will be the primary payer and which will cover extra expenses.

Medicare Open Enrollment 2021

You can sign up for a Medicare Part D plan during the Medicare Open Enrollment period as well as the initial period when you first became eligible for Medicare. The open enrollment period lasts from Oct. 15 to Dec. 7 each year. When you enroll in a plan during the open enrollment period, your coverage goes into effect on Jan. 1 of the next year.

Once you find a Medicare prescription drug plan you’d like to buy, you have a few options on how to begin your coverage.

• Enroll on the Medicare Plan Finder or the insurance company’s website.
• Print and complete a paper enrollment form from the insurance provider.
• Call the plan provider.
• Call 800-MEDICARE (800-633-4227) for assistance enrolling in a plan.

When you sign up for a Medicare Part D plan, you’ll need to provide your Medicare number and the date your Part A and Part B coverage began. You can find this information on your Medicare card. 

Medicare Prescription Drugs Plans Eligibility

To be eligible for a Medicare prescription drug plan, you must meet the following criteria: 

• 65 years of age or older
• Have Original Medicare
• Younger with a qualifying disability 
• Have end-stage renal disease that mandates dialysis or a kidney transplant

The enrollment windows for Medicare prescription drug plans are as follows: 

• Initial enrollment period: Spans a total of 7 months (3 months before your 65th birthday, your birthday month and 3 months following your 65th birthday)
• Annual enrollment period: October 15 to December 7 
• Special enrollment period: You can enroll at any time for select circumstances.

Medicare Prescription Drug Plans Cost

Drug costs under most Medicare Part D plans are low; the amount you pay will vary by provider. There are 5 types of expenses to know: 

• Premiums: The amount paid each month to keep your plan active.
• Annual deductible: The amount you must pay before coverage kicks in. By law, this amount is capped at $435 annually and some plans require no deductible. 
• Copayments: The set amount you pay each time you fill a prescription.
• Coinsurance: The percentage of the drug cost you’re responsible for.
• Coverage gap costs: Applies once your plan covers $4,130 (as of 2021) in drugs — it also means you’ll be responsible for higher out-of-pocket costs. 

Here’s a chart that includes drug costs for Medicare prescription drug plans offered by the top providers in the U.S. 

Compare Medicare Prescription Drug Plans

When comparing Medicare Part D coverage options, you’ll likely want to consider all of the following characteristics:

• Which drugs are covered under each tier
• Deductibles and copays
• Monthly premiums
• Customer service options
• Other online benefits like live chat or account-based plan management

If you aren’t sure where to begin your search, consider a few of Benzinga’s favorite providers below. 

Knowing Your Part D Coverage Options

Understanding the many parts of Medicare can be a challenge. Benzinga has created a comprehensive guide to make getting the coverage you need a little easier. Begin your search for prescription drug coverage with the recommended providers — and return to Benzinga to learn more about Medicare Part D coverage options. 

Frequently Asked Questions

Are you wondering what people are asking for about Medicare? See if you have some of the same questions.

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