Verna Knight, MBA

Licensed Insurance Agent

Prescription Drug Plan


Stand-alone prescription drug coverage refers to Medicare Part D plans purchased separately. Part D coverage is included in 90% of Medicare Advantage plans. Original Medicare beneficiaries are likely to have a Part D plan from one insurer and a Medigap plan from another.

The term “stand-alone” may be used to describe prescription drug coverage for people who are not enrolled in Medicare. Stand-alone drug plans are available in the non-Medicare market, but they are typically prescription discount plans rather than insurance. Because prescription drug coverage is a required benefit under the Affordable Care Act, you don’t need a separate drug plan. Prescription drug coverage is not required for large group plans, but nearly all of them do. Prescription drug coverage is not required in all states’ Medicaid plans, but most do. Although Medicare Part D is true insurance, most people who buy stand-alone drug coverage may be getting a discount program rather than an actual plan. Original Medicare is the only major type of health insurance that does not cover prescription drugs.

How much does it cost?

If your income exceeds a certain threshold, you may be required to pay an additional fee for drug coverage. Because this does not affect everyone, most people will not incur any additional costs. If you have Part B and a higher income, you might have to pay more for Part B. Based on your income, Social Security will contact you if you are required to pay Part D IRMAA. The amount you pay can change as the years come. Click here for more information.

Are you eligible?

To be eligible for Medicare Part D, you must have either Part A or Part B, or both. If you choose a Prescription Drug plan, the plan will cover both Part A and Part B. You can enroll in Part D at specific times of the year. Fall Open Enrollment runs from October 15th to December 7th each year. This is a once-in-a-lifetime opportunity to enroll in a Medicare Advantage Prescription Drug plan. If you qualify for a SEP, it will begin on a specific date and last for a specific period of time.
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