Medicare Part-D

What does Medicare Part D entail?

Medicare Part D is a prescription drug benefit program within the Medicare health insurance system. It is designed to provide coverage for prescription medications to eligible individuals, including those who are 65 years and older, certain individuals with disabilities, and those with end-stage renal disease. Medicare Part D is an optional benefit that is administered by private insurance companies, offering prescription drug coverage to individuals enrolled in Medicare.


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Part D coverage

Every Part D plan maintains a formulary, which is a list of drugs covered by the plan. If your prescribed medication is not included in the formulary, you may need to explore options such as requesting an exception, paying for the drug out of pocket, or filing an appeal.

Drug categories refer to groups of medications that treat similar symptoms or have comparable effects on the body. Part D plans are required to include a minimum of two drugs from most categories and must provide coverage for all drugs in the following categories:

HIV/AIDS treatments


Antipsychotic medications

Anticonvulsive treatments for seizure

Immunosuppressant drugs

Anticancer drugs

Part D Coverage

Part D plans are also responsible for covering most vaccines, excluding those already covered under Part B.


Certain drugs are excluded from Medicare coverage by law, such as medications used for weight loss or gain, as well as over-the-counter drugs.


Please note that in specific cases or under certain circumstances, your medications may be covered by Part A or Part B instead.

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