What Drugs are Covered by Medicare Part D?

Almost nine in 10 adults 65 years and older take at least one prescription medicine. With this in mind, it makes sense that seniors on Medicare need a prescription drug plan to help pay for their medications. Since 2006, Medicare has offered prescription drug coverage for all seniors on Medicare called “Part D.” Kupuna can choose between one of two ways to get Medicare prescription drug coverage. The first option is to join a Medicare Prescription Drug Plan (PDP) and the second is to join a Medicare Advantage Plan that includes prescription drug coverage.

A prescription drug plan is only as good as the medications it covers. In this article we take a look at what drugs are covered by Medicare Part D Plans. If you have specific health issues that are managed with prescription drugs, contact a Medicare Agent for help finding the right drug plan for you.

What Drugs are Covered by Medicare Part D?

Seniors have many individual Part D drug plans to choose from with different co-pays and premiums. All Medicare Part D Plans must cover a wide range of prescription drugs commonly taken by people on Medicare, including the majority of drugs in certain “protected classes.”*

*Medicare’s protected drug classes are anticonvulsants, antineoplastics, antidepressants, antiretrovirals, immunosuppressants, and antipsychotics.

Drug formulary

Most Medicare Drug Plans and Medicare Advantage Plans with prescription drug coverage have a list of the drugs they cover, called a “formulary.” Every formulary includes both brand-name prescription drugs and their generic alternatives, which are considered copies of name-brand drugs. Each formulary must include at least two drug options in the categories and classes most commonly prescribed to seniors.

Drug tiers