Prescription drugs (outpatient)
Medicare Coverage Information
Overview
Medicare provides prescription drug coverage primarily through Part D plans, which help beneficiaries manage the cost of outpatient medications. These plans are offered by private insurance companies approved by Medicare and can help reduce out-of-pocket expenses for prescription drugs.
- Prescription drug coverage is provided through optional Medicare Part D plans
- Coverage includes a wide range of outpatient medications
- Each plan has a formulary (list of covered drugs)
- Costs vary depending on the specific plan and medications
- Some drugs may require prior authorization or have quantity limits
- Must be enrolled in Medicare Part A or Part B
- Available to all Medicare beneficiaries
- Can be added to Original Medicare or Medicare Advantage plans
- No age restrictions for enrollment
- Monthly premiums vary by plan (typically $30-$100)
- Annual deductibles can range from $0 to $545
- Copayments or coinsurance apply for each prescription
- Costs may change during the coverage gap (donut hole)
- Not all medications are covered
- Each plan has a specific formulary of approved drugs
- Some medications may require prior authorization
- Quantity limits may apply to certain prescriptions
- Coverage can change annually
- Review your current medication needs
- Compare different Part D plans during annual enrollment
- Contact Medicare.gov or call 1-800-MEDICARE for plan details
- Consult with your healthcare provider about medication coverage
Last updated: 6/15/2025
Quick Information
- Provider
- Medicare
- Last Updated
- 6/15/2025
- Topics
- Medicare prescription drugsPart D coverageoutpatient medicationsMedicare drug plansprescription drug benefits
Related Coverage Topics
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