Welcome to HAP's Medicare in minutes.


Here we'll focus on Medicare Part D, which is the prescription drug coverage option available under Medicare. Part D coverage can help keep medication costs down. You can enroll when you first become eligible for Medicare. 

Delaying could cost you higher premiums later on. After that, the enrollment period for Part D lasts from October 15th until December 7th each year. 


You can get Part D one of two ways. One, by joining a stand-alone prescription drug plan, PDP.Or two, through a Medicare Advantage plan that offers both health care benefits and prescription coverage.

If you choose stand-alone prescription drug plan, consider adding a Medicare supplement for medical costs not covered by original Medicare. With Part D plans, actual benefits can differ.

For example, you may pay an upfront deductible before your plan starts covering your prescriptions. Then, you may pay copayments or coinsurance until you reach the initial coverage limit.

The initial coverage limit includes what you paid, your deductible, coinsurance, copays, and what your plan paid. The dollar amount of the initial coverage limit changes each year.

If you reach this limit, you enter the coverage gap or donut hole.


Why a donut hole? Because when Part D was first passed, the donut hole described a portion of the benefit where Medicare paid nothing. Like what you find in the hole of a donut.

Now under health reform, that hole is being filled a bit more each year.By 2020 the donut hole is scheduled to cover seventy-five percent of your covered generic and brand name drugs.

And the plan you select may help cover the rest. You'll remain in the donut hole until your costs reach the out of pocket threshold, an amount that includes only what you have paid toward your covered drugs.

Then you will pay only a small for your prescriptions for the rest of the calendar year. The out of pocket threshold changes each year. 



The best news is something not enough people know about. For anyone struggling to pay for their Part D prescription coverage, whether in a Medicare Advantage, Plan Part C, or a stand-alone prescription drug plan,

there may be some help for you. This help is called the Low Income Subsidy, or extra help. This subsidy helps cover prescription drug plan premiums, reduces other out of pocket prescription drug costs,

deductibles, copays, coinsurance, and eliminates the donut hole. So contact social security to see if you might be eligible. Or let a friend in need know about this wonderful program. You can apply for extra help at any time.

And that concludes HAP's Medicare in Minutes Part D Medicare Prescription Drug Coverage. 



HAP believes being smart about Medicare is crucial to helping you get what you need.We sponsor free workshops where you can talk to HAP Medicare experts one-on-one about your questions and concerns. 

We're also available by phone, Monday through Friday 8am to 6pm Eastern Time. You can like us on Facebook at facebook.com/hap or visit hap.org/medicare. HAP is here with resources to make the tough decisions a little easier.

Ask. Learn. Understand your Medicare with a little help from HAP.